Masai Kaori, Ueda Yayoi, Naito Hiromichi, Tsukahara Kohei, Aokage Toshiyuki, Fujisaki Noritomo, Yamamoto Hirotsugu, Nakao Atsunori
Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, Okayama City, Okayama, Japan.
Medicine (Baltimore). 2019 Apr;98(16):e15187. doi: 10.1097/MD.0000000000015187.
Eclampsia, an obstetric emergency frequently seen in pregnant or puerperal women, is a risk factor for posterior reversible encephalopathy syndrome (PRES). Most cases of eclampsia occur postpartum. We report a woman with PRES associated with eclampsia 10 weeks post-delivery, the latest onset ever reported.
A 23-year-old healthy woman presented headache and nausea 10 weeks after delivery. Two days later, she generalized tonic-clonic seizure. Her brain MRI presented the foci which is typical of PRES.
The patient was diagnosed as PRES associated with eclampsia.
The patient received levetiracetam and edaravone.
Her clinical course was uneventful and she fully recovered without neurological complications LESSONS:: The possible diagnosis of late onset postpartum eclampsia, even weeks post-delivery, should be considered, since initiation of early treatment averts severe complications and decreases mortality. Sharing our experience may increase awareness of PRES induced by late-onset postpartum eclampsia.
子痫是一种常见于孕妇或产后妇女的产科急症，是后部可逆性脑病综合征（PRES）的危险因素。大多数子痫病例发生在产后。我们报告一例产后10周发生的与子痫相关的PRES患者，这是有报道以来最晚的发病时间。
一名23岁健康女性在产后10周出现头痛和恶心。两天后，她发生全身强直阵挛性癫痫发作。她的脑部MRI显示出典型的PRES病灶。
该患者被诊断为与子痫相关的PRES。
患者接受了左乙拉西坦和依达拉奉治疗。
她的临床过程平稳，完全康复且无神经并发症。
即使在产后数周，也应考虑迟发性产后子痫的可能诊断，因为早期治疗的启动可避免严重并发症并降低死亡率。分享我们的经验可能会提高对迟发性产后子痫所致PRES的认识。
