Seizure in Pregnancy is not always an Eclampsia

32 years old female primigravida at 32 weeks of gestation presented in post occult phase after having 1 episode of GTCS on 10/05/2021 at 1:00 am in Emergency Room. ABC was managed with stable hemodynamics & normal systemic examination. Pupils B/L 3mm RL & RBS was 198mg/dl.Patient had another episode of GTCS in ER. So Magnesium sulphate 4mg IV was given and patient was diagnosed as a case of Eclampsia. Gynecologist was consulted for further after having a confirmation patient was loaded with IV phosphenytoin. Despite giving the medication patient had 3rd episode of GTCS so MRI brain was done which revealed multiple hyper densities involving cortex & subcortical white matter in both frontal-parietal-occipital lobe & right periventricular region suggesting possibilities of PRES. She was intubated in ER, put on ventilator support and then shifter in the ICU. Patient was taken for LSCS & live fetus was delivered weighing 700gm. Patient was extubated on 11/05/2021 after GCS was improved & absence of any GTCS the necessary precautions needs to be taken care for the safety of the child and mother in any difficulties in delivery.

Author(s): Chirag Jyotirana

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