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KMID : 1031120210110010049
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Journal of Epilepsy Research
2021 Volume.11 No. 1 p.49 ~ p.55
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Posterior Reversible Encephalopathy Syndrome Is the Common Cause of New-Onset Seizures in the Peripartum Period: A Tertiary Hospital-Based Study in South India
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Murthy Jagarlapudi M. K.
Jaiswal Shyam K.
Gaade Keshava Anand
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Abstract
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Background and Purpose: To study the aetiolgic spectrum of new-onset seizures in the peripartum period in south India.
Methods: This is a retrospective analysis of case records of women with new-onset seizures in the peripartum period admitted between 2005 and 2018 (13 years).
Results: Of the 41 women (mean age, 26.20 years; range, 19?35 years) admitted, 20 patients (48.7%) had hypertensive disorders of pregnancy (HDP). Generalized tonic-clonic seizure (88%) was the common seizure type. The aetiologies of new-onset seizures were: 1) pregnancy-related aetiologies in 33 (80.5%) and 2) non-pregnancy-related aetiologies in eight (19.5%). Of the pregnancy-related aetiologies, posterior reversible encephalopathy syndrome (PRES) was the commonest cause in 24 patients (58.5%). Seizure cluster presentation was common in patients with PRES (p=0.0087). Of the eight women with non-pregnancy-related aetiologies, endemic central nervous system (CNS) infections accounted for three (7.3%; brain tuberculoma in one and neurocystocercosis in two) of the aetiology. All the women had Glasgow outcome scale-5 outcome.
Conclusions: PRES was the common cause of new-onset seizures in peripartum period in this cohort. Endemic infections of CNS accounted for 7.3% of the total aetiological spectrum. This study suggests that the possibility of PRES should be considerd in woman with HDP and seizure cluster in peripartum period.
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KEYWORD
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Peripartum period, New-onset seizure, Hypertensive disorders of pregnancy, Posterior reversible leukoencephalopathy syndrome, Cerebral venous thrombosis
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