Posterior Reversible Encephalopathy Syndrome in Late Postpartum Eclampsia: A Case Report

1 Department of Obstetrics and Gynecology, 2 Paik Institute for Clinical Research, Inje University Busan Paik Hospital, Busan, Korea Late postpartum eclampsia is defined as the onset of a seizure more than 48 hours after delivery. Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological entity characterized by clinical manifestations such as seizures, headaches, visual disturbances, altered mental status, and characteristic magnetic resonance imaging findings, including sub-cortical vasogenic edema at the bilateral parietal and occipital lobes. Late postpartum eclampsia concurrent with PRES is rare, and not always preceded by preeclampsia before delivery. We report the case of a 26-year-old woman who developed PRES with late postpartum eclampsia 5 days after cesarean delivery but did not have hypertensive disease during pregnancy.

[1]  A. Rabinstein,et al.  Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions , 2015, The Lancet Neurology.

[2]  L. Magee,et al.  The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. , 2014, Pregnancy hypertension.

[3]  M. Owens,et al.  Posterior reversible encephalopathy syndrome in 46 of 47 patients with eclampsia. , 2013, American journal of obstetrics and gynecology.

[4]  H. Hoshiai,et al.  Reversible posterior leukoencephalopathy syndrome accompanying eclampsia: correct diagnosis using preoperative MRI. , 2012, The Tohoku journal of experimental medicine.

[5]  W. White,et al.  Posterior reversible encephalopathy syndrome and eclampsia: pressing the case for more aggressive blood pressure control. , 2011, Mayo Clinic proceedings.

[6]  M. Jehangir,et al.  Involvement of the cervical cord and medulla in posterior reversible encephalopathy syndrome , 2011, Annals of Saudi medicine.

[7]  H.-J. Lee,et al.  MR Imaging Findings of Medulla Oblongata Involvement in Posterior Reversible Encephalopathy Syndrome Secondary to Hypertension , 2009, American Journal of Neuroradiology.

[8]  P. Striano,et al.  Posterior reversible encephalopathy syndrome in intensive care medicine , 2007, Intensive Care Medicine.

[9]  N. Omori,et al.  Localized lesions on MRI in a case of hypertensive brainstem encephalopathy. , 2005, Internal medicine.

[10]  B. Sibai Diagnosis, prevention, and management of eclampsia. , 2005, Obstetrics and gynecology.

[11]  M. Basta,et al.  Hypertensive encephalopathy with predominant brain stem involvement: MRI findings , 2004, Journal of Human Hypertension.

[12]  John R Barton,et al.  Late postpartum eclampsia: a preventable disease? , 2002, American journal of obstetrics and gynecology.

[13]  L R Caplan,et al.  A reversible posterior leukoencephalopathy syndrome. , 1996, The New England journal of medicine.

[14]  R. Collins,et al.  WHICH ANTICONVULSANT FOR WOMEN WITH ECLAMPSIA - EVIDENCE FROM THE COLLABORATIVE ECLAMPSIA TRIAL , 1995 .

[15]  The Surfaxin-Lavage for Mas Trial Group Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial , 1995, The Lancet.

[16]  B. Sibai,et al.  Late Postpartum Eclampsia Revisited , 1994, Obstetrics and gynecology.