Neuroimaging Features in Eclamptic Encephalopathy

New onset seizures in pregnancy and postpartum are often deemed as eclampsia. Nevertheless, other causes cannot be neglected, and prompt diagnosis and specific measures are crucial for reducing mortality and morbidity.

A new study focused on differentiating the causes of new onset seizures in pregnancy and postpartum, primarily distinguishing eclampsia from other potential causes like intracranial hemorrhage, subarachnoid hemorrhage, cerebral venous sinus thrombosis, or acute ischemic stroke.

This hospital-based descriptive observational study was conducted at SCB Medical College, Odisha, from 2018 to 2020. The research involved 70 clinically confirmed eclampsia cases undergoing cranial MR imaging and routine investigations.

The results revealed that 82.86% of the patients had abnormal MR imaging. The diagnoses were –cortical venous thrombosis without infarction (43.1%), infarction (10.34%), posterior reversible encephalopathy syndrome (32.76%), and hypertensive leukoencephalopathy (13.79%). Notably, the mean gestational age at presentation was significantly lower in the abnormal MRI group. In addition, aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) values were significantly higher in the abnormal MRI group.

It was concluded that patients with imaging abnormalities in eclampsia have a more severe form of the disease. Neuroimaging in cases provisionally diagnosed as eclampsia can modify management strategies, influencing the prognosis for these patients.

Source: Mohapatra K, Sultana NN, Behuria S, Sahoo D, Singh M. The Journal of Obstetrics and Gynecology of India. 2024 Jan 21:1-6.