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Posterior Reversible Encephalopathy Syndrome Complicating Diabetic Ketoacidosis. BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a benign disorder of reversible subcortical vasogenic cerebral edema. CASE CHARACTERISTICS: A 13-yr-old girl presented 4 days after complete recovery from diabetic ketoacidosis with symptoms of headache, altered sensorium, seizures, and visual loss. There was no hypertension or biochemical abnormalities identified. MRI brain showed hyperintense areas in subcortical and periventricular white matter of bilateral fronto-parieto-occipetal lobes, with possible diagnosis of normotensive PRES. OUTCOME: Full recovery without sequelae, following neuro-protection and expectant treatment. MESSAGE: Identifying PRES in diabetic ketoacidosis assists appropriate treatment and prognostication.