Which symptoms are most common before eclampsia seizure?

Updated: Apr 18, 2019
  • Author: Michael G Ross, MD, MPH; Chief Editor: Ronald M Ramus, MD  more...
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Answer

Answer

Although patients with severe preeclampsia are at greater risk for seizures, 25% of patients have symptoms consistent with mild preeclampsia (i.e., preeclampsia without severe features) before the seizures.

A study by Cooray et al found that the most common symptoms that immediately precede eclamptic seizures are neurologic symptoms (ie, headache, with or without visual disturbance), regardless of degree of hypertension. This suggests that closely monitoring patients with these symptoms may provide an early warning for eclampsia. [12]

A retrospective study by Nerenberg et al evaluated 1,565,733 births to determine the incidence rate and relative risk of a seizure disorder after eclampsia. The study reported that eclampsia exclusively affected 1,615 (0.10%) pregnancies, 17,264 (1.1%) with preeclampsia, 60,863 (3.9%) with gestational hypertension, and 1,485,991 (94.9%) remained unaffected. A future seizure disorder was more likely after a pregnancy with eclampsia (4.58/10,000 person-years) than a pregnancy without a hypertensive disorder (0.72/10,000 person-years) however the absolute risk was low (approximately one seizure/2,200 person-years). [13]


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