Veltkamp R, Kupsch A, Polasek J, Yousry T A, Pfister H W
Department of Neurology, Ludwig-Maximilians- University Munich, Klinikum Grosshadern, Munich, Germany.
J Neurol Neurosurg Psychiatry. 2000 Dec;69(6):824-7. doi: 10.1136/jnnp.69.6.824.
In two patients eclampsia started 9 days postpartum. Headache and visual disturbances preceded seizures but none of the classic pre-eclamptic signs oedema, proteinuria, and hypertension were present until shortly before seizure onset. Brain herniation (patient 1) and status epilepticus (patient 2) necessitated neurointensive care management. Brain MRI initially showed only frontal sulcal effacement in one patient but later showed white matter hyperintensities on T2 weighted images and a previously undescribed pattern of cortical-subcortical postgadolinium enhancement on T1 weighted images in both. Neurological deficits and MRI findings were reversed with therapy in both patients. It is concluded that late postpartum eclampsia can manifest without classic prodromi and that characteristic MRI findings may lag behind clinical manifestation.
两名患者在产后9天发生子痫。癫痫发作前出现头痛和视觉障碍，但直到癫痫发作前不久，均未出现子痫前期的典型体征，如水肿、蛋白尿和高血压。脑疝（患者1）和癫痫持续状态（患者2）需要进行神经重症监护管理。脑部MRI最初仅显示一名患者额叶脑沟消失，但后来在两名患者的T2加权图像上均显示白质高信号，在T1加权图像上显示一种先前未描述的皮质-皮质下钆增强模式。两名患者经治疗后神经功能缺损和MRI表现均得到改善。结论是，晚发型产后子痫可无典型前驱症状，且特征性MRI表现可能滞后于临床表现。
