Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Ospedale Guglielmo da Saliceto, Neurology Department, Piacenza, Italy.
Acta Biomed. 2021 Nov 4;92(S1):e2021117. doi: 10.23750/abm.v92iS1.11017.
In the so called COVID19 era, headache, fever and gastrointestinal symptoms are highly suggestive for SARS-CoV-2 infection, but in all the cases presenting to the emergency room, clinicians should always keep in mind alternative diagnoses, particularly if the patient is pregnant. Life-threatening diseases, such as eclampsia and posterior reversible encephalopathy syndrome (PRES), should be promptly recognized and treated. Eclampsia is defined as a seizure occurring in association with pre-eclampsia, and it represents one of the major and serious obstetric disorders associated with significant maternal and perinatal morbidity and mortality. PRES is a distinctive clinical and imaging syndrome characterized by acute headaches, visual impairment, seizures, and altered sensorium, that can be associated with severe eclampsia. Emergency clinicians should always consider eclampsia in the differential diagnosis of headache in pregnant women. The prompt and accurate diagnosis of eclampsia/PRES is crucial to prevent adverse maternal and perinatal outcomes. Here we describe the case of a young pregnant woman admitted to our emergency department for fever, dyspnea, headache, nausea and vomiting, who developed generalized tonic clonic seizures and a subsequent status epilepticus due to eclampsia and PRES.
在所谓的 COVID19 时代，头痛、发热和胃肠道症状高度提示 SARS-CoV-2 感染，但在所有到急诊就诊的病例中，临床医生应始终牢记其他诊断，特别是如果患者怀孕。危及生命的疾病，如子痫和后部可逆性脑病综合征 (PRES)，应及时识别和治疗。子痫是指与子痫前期相关的癫痫发作，是一种主要的严重产科疾病，与严重的母亲和围产儿发病率和死亡率相关。PRES 是一种具有特征性的临床和影像学综合征，表现为急性头痛、视力障碍、癫痫发作和意识改变，可与严重的子痫相关。急诊临床医生应始终将子痫纳入孕妇头痛的鉴别诊断。及时准确地诊断子痫/PRES 对于预防不良的母婴结局至关重要。在这里，我们描述了一位年轻孕妇的病例，她因发热、呼吸困难、头痛、恶心和呕吐到我们的急诊就诊，因子痫和 PRES 发展为全身性强直阵挛性癫痫发作和随后的癫痫持续状态。
