Eclampsia

Sibai, Baha M.; Spinnato, Joseph A.; Watson, D.; Lewis, James A.; Anderson, Garland D.

doi:10.1016/s0002-9378(85)80020-x

Cited by 74 publications

(4 citation statements)

References 16 publications

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“…One of these patients remained in status epilepticus despite treatment with a barbiturate and a benzodiazepine; seizures halted only after administration of general anesthesia and barbiturate coma. She currently has a residual seizure disorder and is maintained on chronic anticonvulsant therapy more than 2 years after delivery, suggesting that peripartum stroke rather than true eclampsia (which should be completely reversible 23 ) was the correct diagnosis. The other patient had a single seizure after therapeutic phenytoin levels were achieved and required only a single dose of a barbiturate.…”

Section: Resultsmentioning

confidence: 99%

Phenytoin Versus Magnesium Sulfate in Preeclampsia: A Pilot Study

et al. 2008

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A randomized clinical trial was designed to determine whether there are clinically demonstrable advantages of phenytoin over magnesium sulfate in preeclamptic patients because of the latter drug's uterine relaxant properties. An intravenous infusion, immediately after randomization, of either phenytoin or magnesium sulfate, with subsequent measurement of serum concentrations and maintenance of therapeutic levels was given to 103 preeclamptic and two eclamptic women. Observed were the rate of cervical dilation during active labor and change in hematocrit between predelivery and 24-hour postdelivery values and the incidence of side effects ascertained by interview. Compared with those receiving magnesium sulfate, patients receiving phenytoin had more rapid cervical dilation (3.3 cm/hr versus 1.5 cm/hr, p = 0.016) and a smaller fall in hematocrit after delivery (-4.7% versus -7.6%, p = 0.034). A significantly lower incidence of hot flushes (15% versus 46%, p < 0.005) and a trend toward less dyspnea and weakness were reported by phenytoin-treated patients. Our phenytoin regimen produced acceptable serum phenytoin levels (10 to 25 micrograms/ml) in 96% of patients.

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Section: Resultsmentioning

confidence: 99%

Phenytoin Versus Magnesium Sulfate in Preeclampsia: A Pilot Study

et al. 2008

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“…Acute severe hypertension with transient loss of autoregulation system (sympathetic innervations) and subsequent vasogenic edema [7, 11] seems the cause of PRES in our patient. Posterior distribution of brain alterations has been attributed to the sympathetic innervations of the cerebral vessels.…”

Section: Discussionmentioning

confidence: 79%

“…Different conditions might be responsible (eclampsia, hypertensive encephalopathy, renal disease with hypertension, neurotoxicity of cyclosporine A or other immunosuppressive drugs and bone marrow transplantation) [4–7]. Other rare pathologic conditions, such as intracranial hypotension, are recently discussed [8, 9].…”

Section: Discussionmentioning

confidence: 99%

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Asymmetric posterior reversible encephalopathy syndrome in patient with hyperplastic anterior choroidal artery

et al. 2011

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We describe a case of asymmetric PRES due to the presence of hyperplastic anterior choroidal artery (AChA) in a man affected by sever hypertension. Posterior reversible encephalopathy syndrome (PRES) has become synonymous with a unique pattern of brain vasogenic edema and predominates in the parietal and occipital regions, accompanied by clinical neurological alterations. Sever hypertension is a risk factor that exceeds the limits of brain autoregulation, leading to breakthrough brain edema. In our knowledge this is the first case reported in literature, in which a similar vascular abnormality is linked to a PRES syndrome.

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Updates on the Treatment of Epilepsy in Women

et al. 2004

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Epilepsy is a condition of the central nervous system that is characterized by recurrent seizures. The goal of management is to make patients seizure free without intolerable adverse effects from treatment. Men and women differ in their physiologic makeup and therefore have different needs that must be considered when attempting to attain this goal. There are special concerns for women of child-bearing years with regard to contraception, pregnancy, and teratogenicity that should be considered during counseling and selection of appropriate treatment. There are also emerging concerns about the interaction of antiepileptic drugs and endocrine function that can affect ovarian function, induce polycystic ovary (PCO)-like syndrome, and threaten fertility. Systemic adverse effects can have a negative impact on weight, cosmetic appearance, sexual function, and bone health. Individualized treatment coupling antiepileptic drug use and the specific phase of impact of the reproductive cycle must be considered in treatment selection. Important concerns regarding long-term therapy are being raised as there are more treatment options to consider because of the plethora of new antiepileptic drugs that are available, often with more favorable pharmacokinetics and different adverse event profiles. Also, sex hormone fluctuations during maturation may exacerbate seizures at particular points during the life cycle for women, including menarche, during menses, during pregnancy, or later in the perimenopausal years, often presenting a uniquely challenging aspect to treatment. As the number of available treatment options for epilepsy increases, the optimal goal for primary care physicians is to work as a team with obstetricians, gynecologists, and neurologists in an effort to ensure the best treatment of women with epilepsy.

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Eclampsia

Cited by 74 publications

References 16 publications

Phenytoin Versus Magnesium Sulfate in Preeclampsia: A Pilot Study

Phenytoin Versus Magnesium Sulfate in Preeclampsia: A Pilot Study

Asymmetric posterior reversible encephalopathy syndrome in patient with hyperplastic anterior choroidal artery

Updates on the Treatment of Epilepsy in Women

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