Müller C, Obhof W, Druschky K F, Ulmer H U
Neurologische Klinik, des Städtischen Klinikums Karisruhe.
Dtsch Med Wochenschr. 1996 Sep 27;121(39):1184-8. doi: 10.1055/s-2008-1043124.
Case 1: A 19-year-old primigravida was hospitalised in the 24th week of pregnancy after a series of grand-mal seizures. Investigation showed the classical eclamptic triad of oedema, hypertension and proteinuria. Case 2: 6 days post-partum a 24-year-old primipara developed hypertension and typical clinical prodromata. Subsequently she had a series of sometimes initially focal grand-mal seizures.
In both cases seizures ceased following pharmacological treatment. The pregnancy in the first case remained intact. Cerebral magnetic resonance imaging (MRI) demonstrated characteristic findings in both cases, in case 1 bilateral disseminated supratentorial foci of oedema without space-occupying features, in case 2 occipital white matter oedema and several supratentorial foci. All changes were completely reversible, in case 1 after 10 days, in case 2 after 16 days.
Together with the clinical findings the focal changes on MRI provide a characteristic picture. MRI can thus be an important aid to the diagnosis of eclampsia and will prevent a misinterpretation as focal encephalitis or venous sinus thrombosis.
病例1：一名19岁初产妇在经历一系列癫痫大发作后，于妊娠第24周住院。检查显示出水肿、高血压和蛋白尿这一典型的子痫三联征。病例2：一名24岁初产妇在产后6天出现高血压及典型的临床前驱症状。随后她出现了一系列癫痫大发作，最初有时为局灶性发作。
两例患者经药物治疗后癫痫发作均停止。第一例患者的妊娠得以维持。脑磁共振成像（MRI）在两例患者中均显示出特征性表现，病例1为双侧幕上弥漫性水肿灶，无占位性病变，病例2为枕叶白质水肿及多个幕上病灶。所有变化均完全可逆，病例1在10天后恢复，病例2在16天后恢复。
结合临床发现，MRI上的局灶性改变呈现出特征性表现。因此，MRI可作为子痫诊断的重要辅助手段，有助于避免误诊为局灶性脑炎或静脉窦血栓形成。
