Sindrome da encefalopatia posteriore reversibile in puerperio, diagnosi e management clinico

Pregnant women with seizures, are usually considered, to be affected by eclampsia until other causes are diagnosed. Eclampsia may be described as the occurrence of convulsions and/or coma during pregnancy, labour or within seven days after delivery when there is no another identifiable cause. However, other diagnosis like epilepsy, encephalitis and tumour should also be considered, especially in the absence of pre-eclamptic symptoms. A patient underwent seizures a few hours after delivery, without pre-eclamptic symptoms, however, the case history and MR images showed typical characteristics of Posterior Reversible Encephalophathy Syndrome (PRES). Even if eclampsia's clinical characteristics could be more variable than commonly assumed, the patient was affected by seizures not due to gestosis; on the contrary, she presented a clinical and neuroradiologic picture leading to PRES. It was remarkable for us to confirm the association between pregnancy and PRES, considering that PRES is a reversible condition if quickly recognized and opportunely treated; as well as to stress the importance of doing an MR in women with seizures.