<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412020000400008</article-id>
<article-id pub-id-type="doi">10.24245/gom.v88i4.3630</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Estudios de imagen cerebral en el diagnóstico diferencial de enfermedades hipertensivas del embarazo y convulsiones. Reporte de dos casos]]></article-title>
<article-title xml:lang="en"><![CDATA[Brain imaging studies in the differential diagnosis of patients with hypertensive diseases of pregnancy and seizures. Report of two cases]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Urquiza y Conde]]></surname>
<given-names><![CDATA[Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Pacheco]]></surname>
<given-names><![CDATA[José Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Ángeles Lomas  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Perinatología Isidro Espinosa de los Reyes Departamento de Terapia Intensiva del Adulto ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<volume>88</volume>
<numero>4</numero>
<fpage>261</fpage>
<lpage>270</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412020000400008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412020000400008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412020000400008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES:  Las crisis convulsivas durante el embarazo son la complicación neurológica más frecuente. Casi todas ocurren en pacientes con epilepsia; cuando aparece la primera durante el embarazo debe establecerse su causa.  PRIMER CASO:  Paciente de 28 años, con antecedente de hipertensión arterial. Cursaba el puerperio posquirúrgico tardío con preeclampsia sobreagregada cuando tuvo tres crisis convulsivas. Acudió a urgencias y la trataron con sulfato de magnesio: evolucionó a estatus epiléptico. Los estudios de neuroimagen reportaron trombosis de la vena cortical frontal izquierda. Se aplicaron medidas de neuroprotección con adecuada evolución clínica y fue dada de alta del hospital sin déficit motor, sensitivo y cognoscitivo.  SEGUNDO CASO:  Paciente de 22 años, con antecedente de citopatía mitocondrial del fenotipo oftalmoplejía externa progresiva crónica. Cursaba su primer embarazo sin control prenatal. A la semana 28 sufrió cefalea y una crisis convulsiva. Acudió a urgencias debido a la hipertensión arterial; le prescribieron un antihipertensivo y sulfato de magnesio. Los estudios de neuroimagen reportaron: síndrome de encefalopatía reversible posterior, secundario a eclampsia. Se interrumpió el embarazo y la paciente evolucionó favorablemente.  CONCLUSIÓN:  Las convulsiones en el embarazo y puerperio en mujeres con enfermedades hipertensivas pueden tener un comportamiento benigno o ser potencialmente mortales. Se propone un algoritmo diagnóstico para tratar a estas pacientes, resalta la sospecha clínica de otras causas de convulsiones como la principal indicación de estudios de imagen.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Crisis convulsivas]]></kwd>
<kwd lng="es"><![CDATA[embarazo]]></kwd>
<kwd lng="es"><![CDATA[epilepsia]]></kwd>
<kwd lng="es"><![CDATA[presión sanguínea elevada]]></kwd>
<kwd lng="es"><![CDATA[preeclampsia]]></kwd>
<kwd lng="es"><![CDATA[sulfato de magnesio]]></kwd>
<kwd lng="es"><![CDATA[agentes antihipertensivos]]></kwd>
<kwd lng="es"><![CDATA[posparto]]></kwd>
<kwd lng="en"><![CDATA[Seizures]]></kwd>
<kwd lng="en"><![CDATA[Pregnancy]]></kwd>
<kwd lng="en"><![CDATA[Epilepsy]]></kwd>
<kwd lng="en"><![CDATA[High blood pressure]]></kwd>
<kwd lng="en"><![CDATA[Preeclampsia]]></kwd>
<kwd lng="en"><![CDATA[Magnesium Sulfate]]></kwd>
<kwd lng="en"><![CDATA[Antihypertensive Agents]]></kwd>
<kwd lng="en"><![CDATA[Pospartum Period]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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