Prichard A, Appiah S, Kearsley R, Arnold G
Department of Anaesthesia Imperial College Healthcare NHS Trust London UK.
Anaesth Rep. 2022 Feb 24;10(1):e12149. doi: 10.1002/anr3.12149. eCollection 2022 Jan-Jun.
Seizures are a rare, but documented, consequence of accidental dural puncture and epidural blood patch. They are also the cardinal feature of eclampsia. We present a postpartum patient who suffered a tonic-clonic seizure within 1 hour of an epidural blood patch procedure for a suspected post-dural puncture headache. Investigations also revealed hypertension, proteinuria and subdural collections. This case demonstrates the diagnostic dilemma associated with postpartum headache and late postpartum eclampsia. We illustrate the importance of a thorough clinical assessment of postpartum patients presenting with headache, highlighting the possibility of more than one underlying pathological cause. We also consider the role of epidural blood patch in both precipitating, and preventing, complications of accidental dural puncture.
癫痫发作是意外硬膜穿刺和硬膜外血贴的一种罕见但有文献记载的后果。它们也是子痫的主要特征。我们报告一名产后患者，在因疑似硬膜穿刺后头痛接受硬膜外血贴操作后1小时内发生了强直阵挛性癫痫发作。检查还发现高血压、蛋白尿和硬膜下积液。该病例展示了与产后头痛和晚发型产后子痫相关的诊断困境。我们阐述了对出现头痛的产后患者进行全面临床评估的重要性，强调了可能存在不止一种潜在病理原因的可能性。我们还探讨了硬膜外血贴在引发和预防意外硬膜穿刺并发症方面的作用。
