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This case report discusses a rare presentation of Posterior Reversible Encephalopathy Syndrome with Spinal Cord Involvement (PRES-SCI) in a four-year-old girl, highlighting its atypical clinical features and MRI findings. The patient exhibited symptoms such as facial palsy, hypertension due to renal disease, and showed significant improvement after prompt diagnosis and management. The report emphasizes the importance of recognizing PRES-SCI in children for better prognosis and outcomes.

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