Atypical Post Partum Eclampsia and Posterior Reversible Encephalopathy Syndrome

Pregnancy  induced  Hypertension also  called as “Gestosis” plural “Gestoses” has a heterogeneous etiology.  A  case  of  atypical  eclampsia  with  seizures  in  the  postpartum,  that  required  intravenous Magnesium sulphate is described. The two proposed theories of etiopathogeniesis of cerebral edema, “Vasogenic  Theory”  and  “Cytotoxic  theory”  are  discussed.  The  concept  of  “delta  hypertension”  is emphasized.  Impaired  fluid  mobilization,  decreased  sodium  excretion  and imbalance  between angiopoietic  factors  in  the  post  partum  period  is  discussed  as  the  likely  cause  of  post  partum eclampsia. It can be concludedthat it is important to monitor blood pressure in the postpartum state. The  patients  of  atypical  postpartum  eclampsia  with  PRES,  are  likely  explained  by  hyper  dynamic circulation,  delta  hypertension  and  vasogenic  theory.  PRES  is  reversible,  has  classical  clinico-radiological features in MRI and has good prognosis with treatment.

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