Posterior reversible encephalopathy syndrome during atypical preeclampsia and eclampsia

Shalina R.I., Kurtser M.A., Shtabnitsky A.M., Kurganskaya M.A., Platitsyn I.V.

1N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow 117997, Ostrovityanova str. 1, Russia; 2Center for Family Planning and Reproduction, Moscow Healthcare Department, Russia; 3Perinatal Medical Center, Moscow 117209, Sevastopolsky Prospect 24, bld. 1, Russia; 4Lapino Clinical Hospital, Moscow region 143081, Odintsovo district, 1st Uspenskoe highway, Village Lapino, 111, Russia
Background. The lack of a downward trend in the incidence of preeclampsia and eclampsia, as well as a larger number of patients with atypical preeclampsia necessitate the identification of objective criteria for evaluating the severity and reversibility of central nervous system lesions in this disease.
Case description. The paper describes a clinical case of a patient who had an attack of postpartum eclampsia with the development of posterior reversible encephalopathy syndrome, as evidenced by magnetic resonance imaging. The diagnosis of preeclampsia was first established at admission to maternity hospital. During therapy after the attack of eclampsia, convulsions did not recur and her status stabilized; repeated magnetic resonance imaging performed four days later showed a reversal of changes in the central nervous system. Magnetic resonance imaging carried out a month after childbirth revealed no abnormalities.
Conclusion. If adequate treatment is performed in due time, the central nervous system changes accompanying eclampsia and manifesting as posterior reversible encephalopathy syndrome are reversible.

Keywords

preeclampsia
atypical preeclampsia
eclampsia
central nervous system lesion
posterior reversible encephalopathy syndrome

Supplementary Materials

  1. Fig. 1. FLAIR, Bilateral hyperintense foci in parietal-occipital areas
  2. Fig. 2. DWI, Edema in parietal-occipital areas (convex surface)
  3. Fig. 3. FLAIR
  4. Fig. 4. DWI

References

1. Sibai B.M., Stella C.L. Diagnosis and management of atypical preeclampsia-eclampsia. Am. J. Obstet. Gynecol. 2009; 200: 481. е1-7.

2. Gupte S., Wagh G. Preeclampsia–eclampsia. J. Obstet. Gynaecol. India. 2014; 64(1): 4-13.

3. Sperling J.D., Dahlke J.D., Huber W.J., Sibai B.M. The role of headache in the classification and management of hypertensive disorders in pregnancy. Obstet. Gynecol. 2015; 126(2): 297-302.

4. Staykov D., Schwab S. Posterior reversible encephalopathy syndrome. J. Intensive Care Med. 2012; 27(1): 11-24.

5. Bogdanov E.I., Hasanov I.A., Mamedov H.I., Hasanov D.M. Differential diagnosis of reversible posterior leukoencephalopathy syndrome and heart attacks in the posterior cerebral artery. Prakticheskaya meditsina. 2012; 8-1: 10-2. (in Russian)

6. Skvortsova V.I., Gubskiy L.V., Melnikova E.A. Reversible posterior leukoencephalopathy syndrome. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2010; 110(5): 104-9. (in Russian)

Received 24.06.2016

Accepted 02.09.2016

About the Authors

Shalina Raisa I., MD, Professor of Obstetrics and Gynecology Department, Pediatric Faculty, N.I. Pirogov Russian National Research Medical University,
Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +79166920318.
E-mail: raisa.shalina@gmail.com
Kurtser Mark A., MD, Corresponding Member of Russian Academy of Sciences, Professor, Department of Obstetrics and Gynecology, Pediatric Faculty, N.I. Pirogov
Russian National Research Medical University, Ministry of Health of Russia.
117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +74955266161. E-mail: m.kurtser@mcclinics.ru
Shtabnitsky Andrei M., Deputy Chief Physician for Anesthesiology and Intensive Care, Perinatal Medical Centre.
117209, Russia, Moscow, Sevastopolsky Prospect 24, bld. 1. Tel.: +74957197896
Kurgan Maria A., clinical intern of the Department of Obstetrics and Gynecology, Pediatric Faculty, N.I. Pirogov Russian National Research Medical University,
Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +79104675239. E-mail: msimuhina@gmil.com
Platitsyn Igor Vladimirovich, PhD, Head of the branch of beam diagnostics service, Lapino Clinical Hospital.
143081, Russia, Moscow region, Odintsovo district, 1st Uspenskoe highway, Village Lapino, 111. Tel.: +74955266161. E-mail: dr.platt@mail.ru

For citations: Shalina R.I., Kurtser M.A., Shtabnitsky A.M., Kurganskaya M.A., Platitsyn I.V. Posterior reversible encephalopathy syndrome during atypical preeclampsia and eclampsia. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (1): 89-93. (in Russian)
http://dx.doi.org/10.18565/aig.2017.1.89-93

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