[Isolated severe neurologic disorders in post-partum: posterior reversible encephalopathy syndrome].
Just after Caesarean section for twin pregnancy and feto-pelvic dysproportion, a woman presented severe headaches and arterial hypertension, then blurred vision, then generalised seizures. There were no oedematous syndrome, proteinuria was negative, ASAT were 1.5 N and platelet count was 120,000/mm(3). Cerebral CT-scan was normal. Posterior reversible encephalopathy syndrome (PRES) was diagnosed on MRI. A second MRI performed at day 9 showed complete regression of cerebral lesions, while patient was taking anti-hypertensive and antiepileptic drugs. PRES has to be evoked in post-partum central neurological symptoms, even in absence of classical sign of pre-eclampsia, like proteinuria. PRES and eclampsia share probably common physiopathological pathways. There management and prognosis seems identical.
Wernet
A
A
Service d'anesthésie et de réanimation chirurgicale, hôpital Beaujon, Clichy la Garenne, France. anne.wernet@bjn.aphp.fr <anne.wernet@bjn.aphp.fr>
Benayoun
L
L
Yver
C
C
Bruno
O
O
Mantz
J
J
D000328:Adult; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001812:Blood-Brain Barrier; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001929:Brain Edema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D002585:Cesarean Section; D003937:Diagnosis, Differential; D004461:Eclampsia / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009529:Nicardipine / Q000627:therapeutic use; D007744:Obstetric Labor Complications / Q000188:drug therapy / Q000503:physiopathology; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011644:Puerperal Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011859:Radiography; D012640:Seizures / Q000188:drug therapy / Q000209:etiology*; D014635:Valproic Acid / Q000627:therapeutic use; D014786:Vision Disorders / Q000209:etiology*
D000927:Anticonvulsants; D000959:Antihypertensive Agents; D014635:Valproic Acid; D009529:Nicardipine