Mandelkern D, Burger A
Department of Neurology, Mount Sinai School of Medicine (CUNY), New York, NY 10029.
Mt Sinai J Med. 1992 Jan;59(1):72-4.
A 23-year-old woman who had an uneventful prenatal course and normal delivery developed severe, generalized headache and blurred vision on postpartum day four. The patient was noted to have generalized hyperreflexia and sustained ankle clonus. The blood pressure was 170/100 mm Hg, there was no edema, and the urine showed trace proteinuria. The visual disturbance rapidly progressed to complete blindness with preserved pupillary reactions. The patient then had a generalized tonic-clonic seizure lasting about one minute. Treatment was initiated with intravenous diazepam and phenytoin, and there was no recurrence of seizure activity. Vision returned to normal and the patient made a complete recovery. This case is presented to demonstrate progressive postpartum pre-eclampsia and the importance of early recognition and treatment. Pathophysiologic mechanisms and treatment options are discussed.
一名产前过程顺利且顺产的23岁女性，在产后第四天出现严重的全身性头痛和视力模糊。该患者被发现有全身性反射亢进和持续性踝阵挛。血压为170/100 mmHg，无水肿，尿液显示微量蛋白尿。视觉障碍迅速发展为完全失明，但瞳孔反应保留。随后患者发生了一次全身性强直阵挛性发作，持续约一分钟。开始静脉注射地西泮和苯妥英钠进行治疗，癫痫活动未再复发。视力恢复正常，患者完全康复。本文展示该病例以说明进行性产后子痫前期以及早期识别和治疗的重要性。并讨论了病理生理机制和治疗选择。
