Late Onset Postpartum Eclampsia: It is Really Never Too Late—A Case of Eclampsia 8 Weeks after Delivery

Minnerup, Jens; Kleffner, Ilka; Wersching, Heike; Zimmermann, Julian; Schäbitz, Wolf‐Rüdiger; Niederstadt, Thomas; Dziewas, Rainer

doi:10.4061/2010/798616

Cited by 16 publications

(16 citation statements)

References 19 publications

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“…The onset in both cases followed an episode of acute hypertension, which in Patient 1 was associated with late-onset postpartum pre-eclampsia. Instances of delayed eclampsia and preeclampsia with PRES within several weeks after delivery have been reported in the literature and Patient 1's history, acute neurological presentation, and neuroimaging findings are consistent with other reported cases of delayed pre-eclampsia/ eclampsia with PRES (Bartynski & Sanghvi, 2003;Chiou & Chen, 2007;Delefosse et al, 2003;Kaunita, Valsalan, Seshadri, Pandit, & Prabhu, 2009;Minnerup et al, 2010;Pizon & Wolfson, 2005). Patient 2 suffered from lupus and a seizure disorder, both of which are common in the histories of PRES patients.…”

Section: Discussionsupporting

confidence: 77%

Long-term Neurocognitive and Neuroimaging Outcomes in Posterior Reversible Encephalopathy Syndrome: Two Case Reports and Implications

Stroescu

Salinas

Nahab

et al. 2011

The Clinical Neuropsychologist

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Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic and neurometabolic state associated with a distinct appearance on computed tomography and magnetic resonance imaging, as well as particular clinical features. While PRES is defined as a reversible condition, instances of irreversible or persisting cytotoxic edema have been reported and appear to be associated with poor outcomes. Studies addressing the post-acute neurocognitive findings in persisting/irreversible PRES are lacking. We report two cases of persisting PRES with associated neurocognitive deficits and functional limitations following acute presentation. Neuroimaging revealed abnormalities within the posterior parietal lobes, along with bilateral involvement of the occipital and frontal lobes. The results from the neuropsychological examination revealed a pattern of impairment generally affecting spatial-perceptual and related functions and aspects of executive function. These cases document instances of irreversible/persisting PRES with associated neurocognitive deficits and functional limitations generally corresponding with the areas implicated on neuroimaging. Studies addressing the post-acute neurocognitive presentation and functional outcomes of PRES are needed.

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Section: Discussionsupporting

confidence: 77%

Long-term Neurocognitive and Neuroimaging Outcomes in Posterior Reversible Encephalopathy Syndrome: Two Case Reports and Implications

Stroescu

Salinas

Nahab

et al. 2011

The Clinical Neuropsychologist

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“…( 5,6 ). There has also been claim of such a case after 8 weeks of delivery (16). In our series there were two cases of late onset eclampsia being on 7 th and 12 th day.…”

Section: Discussionsupporting

confidence: 50%

Clinical Study of Postpartum Eclampsia

2016

IJSR

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Eclampsia continues to be one of the leading causes of Maternal morbidity and mortality in developing countries. It is true that with the outreach of Governments and Non Government agencies, more women are able to access antenatal care. This has increased the scope of early detection of cases of hypertension during pregnancy and thereby preventing development of eclampsia. However, with the degree of watchfulness abating in postnatal period, risk of development of postpartum eclampsia, particularly late onset ones looms large. We analyzed the data pertaining to eclampsia cases encountered in our hospital for two years and found that there is a relative rise in the incidence of postpartum eclampsia. Treatment protocol remains the same but the outcome is better with less chances of complicating other systems when compared with antenatal and intranatal variants.

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“…In addition, MRA suggested features of vasoconstriction or string-of-beads appearance, which are reflective of brain hypoperfusion (3,10). Notably, cerebral venous vasodilation was also observed in the current patient, which has seldom been reported in the literature (6,8). This abnormal venous vasodilation in addition to the arterial vasoconstriction were completely reversed following the aforementioned treatments, resulting in the patient's recovery.…”

Section: A B C Dsupporting

confidence: 52%

“…The patient reported in the present study did not demonstrate typical pre-eclamptic prodromes, although she experienced hypertension and limb edema during her pregnancy, and presented with convulsions 5 weeks after the delivery. To the best of our knowledge, only one patient reported in the literature experienced LPE with onset later than 4 weeks postpartum (8). LPE may manifest as RPES in which the most frequently affected areas are the subcortical white matter in the cerebral posterior circulation region (9).…”

Section: A B C Dmentioning

confidence: 99%

Reversible posterior encephalopathy syndrome associated with late onset postpartum eclampsia: A case report

Yang

Wang

2016

Experimental and Therapeutic Medicine

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Abstract. Late onset postpartum eclampsia (LPE) is defined by its onset at >48 h after delivery. Reversible posterior encephalopathy syndrome (RPES) associated with LPE is uncommon, with the majority of RPES cases having a late postpartum onset within 4 weeks after childbirth. The present study reported the case of a 15-year old female presenting with convulsions that began 5 weeks after delivery. A magnetic resonance imaging scan of the brain revealed multiple lesions in the cortex, subcortical region and deep white matter of the bilateral cerebellum, and occipital, frontal and parietal lobes. The clinical manifestations and radiological abnormalities were readily resolved subsequent to antihypertension and anticonvulsion treatment. In conclusion, the present rare case indicates that LPE should be considered as a potential diagnosis even at 4 weeks after delivery. Furthermore, clinicians should familiarize with the reversible radioimaging features of RPES, since early recognition and adequate treatment are important to the outcome of patients.

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Late Onset Postpartum Eclampsia: It is Really Never Too Late—A Case of Eclampsia 8 Weeks after Delivery

Cited by 16 publications

References 19 publications

Long-term Neurocognitive and Neuroimaging Outcomes in Posterior Reversible Encephalopathy Syndrome: Two Case Reports and Implications

Long-term Neurocognitive and Neuroimaging Outcomes in Posterior Reversible Encephalopathy Syndrome: Two Case Reports and Implications

Clinical Study of Postpartum Eclampsia

Reversible posterior encephalopathy syndrome associated with late onset postpartum eclampsia: A case report

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