Clinical and radiological analyses of reversible posterior leukoencephalopathy syndromes in preeclampsia/eclampsia / 中国医师杂志

ABSTRACT

Objective To investigate clinical and radiological characteristics of reversible posterior leukoencephalopathy syndromes(RPLS) in preeclampsia/eclampsia and to summarize prognosis of patients and fetus in order to provide the basis for early diagnosis and early treatment.Methods Clinical and radiological characteristics, and treatments and outcomes of 33 pregnant women with RPLS in preeclampsia/eclampsia were analyzed retrospectively.All patients were treated in Guangzhou Medical Center for Critical Pregnant Women during January 2013 and July 2015.Results Clinical symptoms :23 of 33 patients were with headache, 19 cases with visual changes, 15 with seizures, and 12 cases with conscious or mental disorder besides 3 cases with nausea and vomiting, and 4 cases with chest tightness and shortness of breath symptoms.Imaging features: 33 cases were all checked with radiological examination in acute period, which suggests edema of white matter.It involved the most common parts of occipital lobe(24 cases), 13 cases in the parietal lobe,9 cases in temporal lobe and basal ganglia,and 6 cases in frontal lobe.Moreover, the common parts involving the brain stem occurred in 4 cases, and 2 cases of cerebellum.Clinical outcomes: 33 cases of pregnant women in prenatal emergency termination of pregnancy include 31 cases of cesarean section, and 1 case of natural delivery.After active treatment, the prognosis was good, except 1 case complicated with systemic lupus erythematosus (SLE) died, the rest were good.Fetal prognosis : stillbirths occurred in 8 cases, the rest were good.Conclusions The clinical presentations of RPLS in patients with eclampsia or preeclampsia are typical, including headache, epileptic seizures, visual changes, conscious, or mental disorder.The imaging features which involved the most common parts are occipital lobe and parietal lobe.The early diagnosis and timely intervention lead to a sound prognosis.