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妊娠晚期癫痫发作——一例罕见的酷似子痫的韦尼克脑病病例。

Seizures in the third trimester of pregnancy- A rare case of Wernicke's encephalopathy mimicking Eclampsia.

作者信息

Bannour Badra, Baazaoui Maroi, Bannour Maroi, Bannour Imen, Abdellaoui Hiba, Ben Jazia Khaled

机构信息

Department of obstetrics and gynecology, university hospital Farhat Hached of Sousse.

University of Sousse, faculty of medicine of Sousse, Tunisia.

出版信息

Radiol Case Rep. 2024 Mar 1;19(5):2039-2042. doi: 10.1016/j.radcr.2024.02.031. eCollection 2024 May.

Abstract

Unless otherwise demonstrated, seizures during pregnancy that happen after 20 weeks of gestation are typically caused by eclampsia. In our clinical case we report the diagnostic challenge of Wernicke's encephalopathy occurring at 34 weeks and mimicking an eclamptic attack. This is about a 30-year-old female patient who suffers from hyperemesis gravidarum during her pregnancy. she has no known history of epilepsy .The patient was brought to the emergency room by medical transport at 34 weeks of gestation due to a seizure at home. The initial diagnosis was eclampsia. Emergency high-level extraction under general anesthesia was decided for maternal rescue. However, after extubation, the patient's condition deteriorated, with the onset of a confusion syndrome characterized by agitation, temporal-spatial disorientation, attention and vigilance disorders, and challenging communication. Angio MRI was performed, revealing signs consistent with Wernicke's encephalitis.

摘要

除非另有证明,妊娠20周后发生的癫痫发作通常由子痫引起。在我们的临床病例中,我们报告了一名34周妊娠时发生的韦尼克脑病的诊断挑战,该病例表现类似子痫发作。这是一名30岁的女性患者,孕期患有妊娠剧吐。她既往无癫痫病史。该患者在妊娠34周时因在家中癫痫发作被医疗转运至急诊室。初步诊断为子痫。为挽救产妇生命,决定在全身麻醉下进行紧急高位剖宫产。然而,拔管后,患者病情恶化,出现了以躁动、时空定向障碍、注意力和警觉性障碍以及沟通困难为特征的意识模糊综合征。进行了血管MRI检查,结果显示与韦尼克脑炎相符的征象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/197e/10917636/c51c723023c9/gr1.jpg

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