The occurrence of one or more convulsions in a pre-eclamptic womanin the absence of any other neurological or metabolic cause
Aetiology
All patients with pre-eclampsia are at risk of developing eclampsia
Eclampsia is more common in teenagers
Clinical presentation
The hallmark feature of eclampsia is a new onset tonic-clonic type seizure, in the presence of pre-eclampsia
Other signs and symptoms include:
Headache (usually frontal)
Hyper-reflexia
Nausea and vomiting
Generalised oedema
Right upper quadrant pain +/- jaundice
Visual disturbances e.g. flashing lights, blurred or double vision
Change in mental state
Investigations
Investigations in suspected eclampsia are used to exclude other reversible causes (such as hypoglycaemia), and assess for any complications (such as DIC or HELLP syndrome)
FBC, U+Es, LFTs, clotting studies, blood glucose
It may be necessary to rule out other causes of seizures if there is any doubt regarding the diagnosis of eclampsia
e.g. if there is a history of head trauma or seizure onset in the 1st trimester, this is more likely to be associated with CNS pathology and requires a full neurological work-up including CT/ MRI head.
Management
Control BP - IV labetolol, IV hydralazine
Stop seizures - IV magnesium sulphate, if persistent seizures consider IV diazepam
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