Open AccessAtypical case of posterior reversible encephalopathy syndrome related to late onset postpartum eclampsia
Author(s) -
Kaori Masai,
Yayoi Ueda,
Hiromichi Naito,
Kohei Tsukahara,
Toshiyuki Aokage,
Noritomo Fujisaki,
Hirotsugu Yamamoto,
Atsunori Nakao
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000015187
Subject(s) - medicine , posterior reversible encephalopathy syndrome , eclampsia , hellp syndrome , nausea , levetiracetam , pregnancy , encephalopathy , pediatrics , postpartum period , anesthesia , obstetrics , epilepsy , magnetic resonance imaging , radiology , psychiatry , biology , genetics
Rationale: Eclampsia, an obstetric emergency frequently seen in pregnant or puerperal women, is a risk factor for posterior reversible encephalopathy syndrome (PRES). Most cases of eclampsia occur postpartum. We report a woman with PRES associated with eclampsia 10 weeks post-delivery, the latest onset ever reported. Patient concerns: A 23-year-old healthy woman presented headache and nausea 10 weeks after delivery. Two days later, she generalized tonic-clonic seizure. Her brain MRI presented the foci which is typical of PRES. Diagnosis: The patient was diagnosed as PRES associated with eclampsia. Interventions: The patient received levetiracetam and edaravone. Outcomes: Her clinical course was uneventful and she fully recovered without neurological complications Lessons: The possible diagnosis of late onset postpartum eclampsia, even weeks post-delivery, should be considered, since initiation of early treatment averts severe complications and decreases mortality. Sharing our experience may increase awareness of PRES induced by late-onset postpartum eclampsia.