Eclampsia: intercurrent presentation and cerebral findings
THE CONTEXT
Eclampsia may be classified by the timing of convulsions. Cerebral abnormalities and atypical neurological features guide further assessment.
Timing and intercurrent eclampsia
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Late postpartum eclampsia refers to fits occurring beyond 48 hours but less than 4 weeks after delivery.
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Intercurrent antenatal eclampsia describes recovery of consciousness after convulsions with pregnancy continuing beyond 48 hours. This time limit is arbitrary; a period of 7–10 days has also been mentioned.
Cerebral pathology
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Cerebral pathology includes cortical or subcortical edema, infarction and hemorrhage.
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Neurological abnormalities are often attributable to hypoxia, ischemia or edema.
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Neurodiagnostic investigations may reveal edema and infarction, with findings similar to hypertensive encephalopathy.
Imaging indications and findings
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Cerebral MRI is indicated for focal neurological deficits, prolonged coma or an atypical presentation of eclampsia.
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Important imaging findings include patchy and diffuse areas of low density, occipital white matter edema, cerebral hemorrhage and infarctions.