Classification of CSF samples from normal and post-partum psychotic women using chromatographic profiles with bilinear projections: a multivariate approach.

This paper demonstrates how chromatographic profiles of cerebrospinal fluid (CSF) have been subjected to multivariate data analysis to discriminate between CSF samples from women with post-partum psychosis and those from healthy women. Instead of peak-heights or areas, digitally defined chromatographic profiles were examined using principal component analysis (PCA). In accordance with the diagnosis, we have found a complex profile pattern of at least ten composite peaks that discriminates between these groups. Two of these peaks were for the discrimination particularly clearly between the two groups. We speculate that these findings can be useful in the diagnosis of post-partum psychosis, increasing diagnostic precision and having both clinical and prognostic implications.

Postpartum headache, seizures and bloodstained C.S.F.: a possible complication of dural puncture?

A 32-year-old parturient developed severe headache with subsequent convulsions on the third day after the delivery under epidural anesthesia. Neuroradiological investigations were negative. All complaints disappeared promptly after the performance of an epidural blood patch.

[Hypoglycorrhachia and postpartum aseptic cerebral thrombophlebitis with meningeal hemorrhage]. / Hypoglycorachie et thrombophlébite cérébrale aseptique du post-partum avec hémorragie méningée.

A 42-year-old woman had a puerperal aseptic cerebral thrombophlebitis with repeated episodes of subarachnoid hemorrhage. Cerebrospinal fluid studies revealed a delayed, severe and lasting low sugar and high protein levels. The possible mechanisms of low sugar levels are discussed.

CSF and plasma beta-casomorphin-like opioid peptides in postpartum psychosis.

The authors measured opioid receptor-active components in the CSF of 11 women with postpartum psychosis, 11 healthy lactating women, and 16 healthy women who were not lactating. Activity that eluted with 0.2 M acetic acid 0.7-0.9 times the total volume of the column (fraction II activity) was significantly higher in the CSF of both healthy and psychotic women in the puerperium than in that of the lactating women. Very high levels of fraction II activity were seen in four psychotic patients. Material from these patients was further characterized by electrophoresis and high-performance liquid chromatography: The material migrated as bovine beta-casomorphin. Receptor-active material with the same characteristics was also found in the plasma of these four patients. The authors conclude that certain cases of postpartum psychosis are associated with the occurrence in plasma and CSF of unique opioid peptides probably related to bovine beta-casomorphin.

[Subacute encephalitis during lactation (author's transl)]. / Subakute Enzephalitis in der Laktation

Two cases of encephalitis during lactation are reported. The illness started with psychotic symptoms and some weeks later neurological disturbances appeared. The course of the illness was subacute and both cases the brain scan was abnormal with numerous nodules. A CSF proteinogram showed an acute phase reaction, pointing to an organic lesion of the nervous system, but no impairment of the blood CSF barrier and normal immunoglobulin G levels. The possible aetiological factors, as well as the CSF and brain scan findings are discussed.