Neurological complications of eclampsia
Sawhney, I.M.; Subrahmanyan, A.V.; Das, C.P.; Khandelwal, N.; Sawhney, H.; Vasishta, K.
Journal of the Association of Physicians of India 47(11): 1068-1071
1999
ISSN/ISBN: 0004-5772 PMID: 10862315 Document Number: 502698
A prospective study was conducted to evaluate the various neurological (clinical, radiological and EEG) complications in patients of eclampsia. Thirty nine patients of eclampsia were studied regarding neurological findings at presentation and electroencephalographic (EEG) tracings were recorded in each patient. Patients with an abnormal neurologic examination and/or focal or lateralizing findings on EEG, underwent a CT scan (n = 18). Foetal and maternal outcome were recorded. The age of the patients ranged from 19-30 (mean +/- SD, 24.2 +/- 3.5) years thirty six patients (92%) had seizures in the antenatal period, 2 (5.4%) patients developed post partum eclampsia and 1 (2.6%) patient had seizures before and after delivery. A diffuse encephalopathy was seen in 9 patients (23.1%), 4 patients (10.2%) had hemiparesis and 1 patient (2.6%) had papilledema. EEG abnormalities were seen in 29 cases (74%) and included generalized slowing (n = 19), generalized sharp waves (n = 9), focal slowing (n = 4), focal sharp waves (n = 2) and spikes (generalized and focal) were seen in 1 patient each. Abnormal CT scan was seen in 10 cases (n = 18). Five patients had generalized infarct was seen in 1 patient each. There were 8 (20.5%) still births and 31 (19.5%) live births and no maternal mortality. Antenatal seizures occur in > 90% cases of eclampsia and less than 10% cases have seizures after delivery. A diffuse encephalopathy is the commonest clinical abnormality along with generalized slowing on EEG. Although cerebral oedema is common focal infarcts may be seen on CT scan.