Reversible Posterior Leucoencephalopathy Syndrome Following Duloxetine: A Case Report and Review of Literature

Abstract

Reversible Posterior Leucoencephalopathy Syndrome (RPLS) is a disorder characterized by headaches, confusion, and/or decreased level of consciousness, seizures, and visual changes. A 58-year-old female was found unresponsive, with generalized rigidity and urinary incontinence for unknown duration. On presentation, she was febrile, tachycardic, tachypneic, and hypertensive. Neurological exam showed increased muscle tone and brisk deep tendon reflexes. Brain MRI revealed gyriform edema and white matter hypodensities in parieto-occipital regions consistent with RPLS. Discontinuation of duloxetine, one of her home medications, led to resolution of symptoms. We report this case to discuss the syndrome of RPLS and propose the role of duloxetine in causing hypertension and cerebral vasoconstriction leading to RPLS. To our knowledge, this is the first reported case of RPLS resulting from the use of duloxetine.




J Med Cases. 2011;2(1):24-27
doi: https://doi.org/10.4021/jmc98w