From darkness to light: A child`s battle for the sight–A rare case report with review of literature

Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological entity marked by distinctive clinical features and corroborated by Magnetic Resonance Imaging. Despite its alarming presentation, PRES is often reversible with appropriate management, showing favourable radiographic and clinical outcomes. Scorpion bite leading to PRES is a rare clinical presentation. Here we have described a case of 4 year old girl with a history of scorpion bite presented with headache, vomiting and seizure with altered sensorium. Based on imaging findings and excluding all other possible causes, diagnosis of PRES was considered. With appropriate treatment there was significant improvement in her symptoms. This is the first case reported from Asia, and it aligns with previous documented reports indicating the potential for scorpion bite to induce PRES. In the context of scorpion stings, PRES is hypothesized to result from a catecholamine surge causing endothelial dysfunction, blood-brain barrier disruption, and autonomic dysregulation. This case underscores the potential of scorpion stings to cause PRES, emphasizing the importance of early recognition and intervention. Further research is required to know the underlying mechanisms and improve management strategies. • PRES is a severe neurological condition presenting with diverse symptoms like seizure, headache, altered sensorium, or focal neurological deficit. • However, with early and appropriate management, it is treatable and has a favourable outcome. • The precise mechanism of PRES in normotensive patients remains unclear and warrants further studies. • Scorpion stings resulting in PRES are rare, but they can be seen in the pediatric population, even in normotensive patients.