Seizures in the early post-partum period: A diagnostic dilemma.
We discuss the differential diagnosis and management of early post-partum seizures and headache following a presumed dural puncture in a 20-year-old female. She initially presented with generalised tonic-clonic seizures preceded by nausea and headache on the fourth post-partum day along with a decreased Glasgow Coma Scale (8/15). Although clinical and laboratory examination including lumbar puncture, computerized tomography and magnetic resonance imaging were normal, a persistent headache was the only symptom. This headache improved dramatically after an epidural blood patch on the eighth post-partum day. The following discussion emphasises that various causes of post-partum seizures and headache should be considered before attributing it to dural puncture alone.
Department of Anaesthesia, Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury SY3 8XQ, UK.
Sunil
S
Jamadarkhana
Robert C
RC
Law