Cerebral manifestation of eclampsia:: A case report

A gravida 5, para 4 presented with generalized tonic-clonic seizures in the 37th week of gestation. The previous course of the pregnancy had been uneventful. Blood pressure was normal and there was no proteinuria or edema. A magnetic resonance scan of the brain was obtained to rule out intracranial bleeding, sinus vein thrombosis and encephalitis. The scan showed the characteristic findings of eclampsia, Seven hours after the seizure the patient was delivered vaginally of a slightly growth retarded male newborn. The further course was uneventful and the cerebral changes resolved without specific treatment. Eclamptic seizures are generally considered due to the failure of autoregulatory mechanisms and subsequent endothelial damage and vasogenic, cerebral edema. Without systemic hypertension this hypothesis is unsatisfactory. Endothelial dysfunction with increased vascular sensitivity to vasopressors is a more likely mechanism.