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A 21-year-old pregnant female with no significant past medical history presented with acute onsetheadache and nausea as well as tonic-clonic seizures, then rapidly decompensated into a coma withcomplete absence of brainstem reflexes. The patient was ultimately diagnosed with hemolysis, elevatedliver enzymes, and low platelets (HELLP syndrome) and subsequent posterior reversible encephalopathysyndrome (PRES) with brainstem involvement. Emergent delivery and blood pressure control resulted inrapid and complete neurologic recovery.
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