Servicios Personalizados
Revista
Articulo
Indicadores
- Citado por SciELO
- Accesos
Links relacionados
- Similares en SciELO
Compartir
Ginecología y obstetricia de México
versión impresa ISSN 0300-9041
Resumen
URQUIZA Y CONDE, Fernando y HERNANDEZ-PACHECO, José Antonio. Brain imaging studies in the differential diagnosis of patients with hypertensive diseases of pregnancy and seizures. Report of two cases. Ginecol. obstet. Méx. [online]. 2020, vol.88, n.4, pp.261-270. Epub 30-Ago-2021. ISSN 0300-9041. https://doi.org/10.24245/gom.v88i4.3630.
BACKGROUND:
Seizures during pregnancy are the most frequent neurological complication. Most occur in patients with epilepsy. When the first crisis appears during pregnancy, the cause must be determined.
FIRST CASE:
A 28-year-old patient with a history of high blood pressure. She was in the late puerperium with over-added preeclampsia when she presented three seizures. She went to the emergency room and started magnesium sulfate, evolving to epileptic status. Neuroimaging studies were performed and reported thrombosis of the left frontal cortical vein. Neuroprotection measures were applied with adequate clinical evolution. She was discharge without motor, sensory and cognitive deficits.
SECOND CASE:
A 22-year-old patient with a history of a chronic progressive external ophthalmoplegia mitochondrial cytopathy. She was in her first pregnancy without prenatal control. At the 28 week she began with headache and had a seizure. She went to the emergency department with high blood pressure, so she was given antihypertensive therapy and magnesium sulfate. Neuroimaging studies reported a posterior reversible encephalopathy syndrome secondary to eclampsia. The pregnancy was interrupted, and she evolved favorably.
CONCLUSION:
Seizures in pregnancy and puerperium in women with hypertensive diseases of pregnancy may have benign behavior or may be life-threatening. We propose a diagnostic algorithm for the approach of these patients, highlighting the clinical suspicion of other causes of seizures as the main indication of imaging studies.
Palabras llave : Seizures; Pregnancy; Epilepsy; High blood pressure; Preeclampsia; Magnesium Sulfate; Antihypertensive Agents; Pospartum Period.