title: Neurology of pregnancy.
abstract: Pregnancy creates alterations in maternal physiology which predispose to unique neurologic disorders. Pre-eclampsia, eclampsia, certain types of ischemic and hemorrhagic stroke, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome, and thunderclap headache all appear to share a common origin from vascular endothelial dysfunction, with overlapping clinical presentations. Multiple sclerosis often improves during pregnancy. Compression mononeuropathies may occur in the extremities. Myasthenia gravis may affect second stage labor. Various inflammatory peripheral neuropathies, dystrophies, myopathies may occur during pregnancy. The safety of specific immune suppressants is reviewed. Epilepsy does not have a significant effect upon the course of pregnancy, albeit there is a modest increase in the need for cesarean section. Certain antiepileptic drugs may produce fetal malformations, most notably valproic acid. Brain tumors are rare during pregnancy, but may increase in size due to activation of hormonal receptors on tumor cells surfaces, water retention, and engorged blood vessels.
authors.affiliation: Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA.
authors.forename: H Steven
authors.initials: HS
authors.lastname: Block
authors.affiliation: Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA. Electronic address: jbiller@lumc.edu.
authors.forename: José
authors.initials: J
authors.lastname: Biller
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000150:complications; D004461:Eclampsia; D004827:Epilepsy / Q000209:etiology; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications; D009422:Nervous System Diseases / Q000209:etiology*; D009468:Neuromuscular Diseases / Q000150:complications; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D020521:Stroke / Q000150:complications
keywords: Pre-eclampsia; cerebral venous thrombosis; compression mononeuropathies; eclampsia; fetal malformation; multiple sclerosis; peripartum cardiomyopathy; pituitary apoplexy; posterior reversible encephalopathy syndrome; reversible cerebral vasoconstriction syndrome