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a Department of
Neurology, Ludwig-Maximilians- University Munich, Klinikum
Grosshadern, Munich, Germany, b Institute for Anesthesiology, c Department of Neuroradiology, d Department
of Neurology, Ruprecht-Karls- University Heidelberg, Im Neuenheimer
Feld 400, 69120 Heidelberg, Germany, e Department of Neurology, Charité, Humboldt
University, Berlin, Germany
Correspondence to: Dr Roland Veltkamp rcveltkamp{at}t-online.de
Received 1 September
1999 and in revised form 12 June 2000;
Accepted 14 August
2000
In two patients eclampsia started 9 days postpartum. Headache
and visual disturbances preceded seizures but none of the classic pre-eclamptic signs oedema, proteinuria, and hypertension were present
until shortly before seizure onset. Brain herniation (patient 1) and
status epilepticus (patient 2) necessitated neurointensive care
management. Brain MRI initially showed only frontal sulcal effacement
in one patient but later showed white matter hyperintensities on T2
weighted images and a previously undescribed pattern of cortical-subcortical postgadolinium enhancement on T1 weighted images
in both. Neurological deficits and MRI findings were reversed with
therapy in both patients. It is concluded that late postpartum eclampsia can manifest without classic prodromi and that characteristic MRI findings may lag behind clinical manifestation.
This article has been cited by other articles:
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  N. Munjuluri, M. Lipman, A. Valentine, P. Hardiman, and A. B Maclean Postpartum eclampsia of late onset BMJ, November 5, 2005; 331(7524): 1070 - 1071. [Full Text] [PDF]
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