Kaplan P W
Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA.
Rev Neurol (Paris). 1999 May;155(5):335-41.
Preeclampsia/eclampsia is a complex multisystem disorder with potentially severe, irreversible sequelae. Much of the morbidity involves the central nervous system. Neurologists can make important contributions to the management of eclampsia. In consultation with their obstetric colleagues they can provide input to the investigation of intracerebral vascular events, the management of seizures and raised intracranial pressure. Particularly in the case of eclampsia at early gestational ages, input on the severity and nature of the neurologic problem will assist the obstetrician in determining whether to expedite or delay delivery. Recent multicenter studies show a benefit of magnesium sulfate over either phenytoin or diazepam in the prevention of seizures, but questions about the conclusions remain. More basic and clinical research is needed, particularly on the pathophysiology of seizures and eclamptic vasospastic components, in order to provide a better understanding and consequently to design optimal therapy. The challenge includes finding an appropriate animal model for this disease with which to test such therapies.
子痫前期/子痫是一种复杂的多系统疾病，可能会导致严重的、不可逆的后遗症。其发病多累及中枢神经系统。神经科医生可为子痫的治疗做出重要贡献。与产科同事协商后，他们可为脑血管事件的调查、癫痫发作及颅内压升高的管理提供意见。特别是在早孕子痫的情况下，关于神经问题的严重程度和性质的意见将有助于产科医生决定是加快还是延迟分娩。最近的多中心研究表明，硫酸镁在预防癫痫发作方面优于苯妥英钠或地西泮，但关于这些结论仍存在疑问。需要更多的基础和临床研究，特别是关于癫痫发作和子痫性血管痉挛成分的病理生理学，以便更好地理解并因此设计出最佳治疗方案。挑战包括找到一种适合该疾病的动物模型来测试此类疗法。
