Eclampsia. IV. Neurological findings and future outcome.

Sixty-five patients with eclampsia were longitudinally evaluated regarding neurological abnormalities and maternal outcome (6 to 42 months) after eclampsia. Electroencephalograms were obtained on all patients during the subsequent 6 months. Computerized axial tomographic scans (n = 20) and cerebral arteriograms (n = 3) were obtained on patients with neurological deficits and/or those with an atypical clinical course. The electroencephalogram was abnormal in 49 patients (75%) at initial assessment but gradually returned to normal in all observed patients within 6 months. Cerebral arteriograms and computerized axial tomographic scans were normal in each patient studied. None of the patients had neurological deficits or subsequent convulsions on follow-up examination. Thirty-eight patients had one or more subsequent pregnancies without recurrent eclampsia, but 14 (37%) had pregnancy-induced hypertension. The findings suggest that neurological events of eclampsia are acute and transient and that long-term neurological deficit is rare in the properly managed patient. Computerized axial tomography and electroencephalography are rarely indicated in the management of such patients.