Reversible posterior leukoencephalopathy syndrome (RPLS), better known as Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological diagnosis characterized by confusion, seizures, headache, vomiting, and loss of vision with imaging studies indicating predominantly posterior leukoencephalopathy. PRES is the end result of various etiological factors that lead to blood brain barrier injury either by hyper– or hypoperfusion, endothelial dysfunction, changes in blood vessel morphology, hypocapnia or immune system activation.