[Neurological spectrum of pre-eclampsia and eclampsia]

Preeclampsia is a disorder specific to pregnancy which can affect all maternal organs. Cerebral involvement with the occurrence of convulsions is the defining factor for eclampsia. The most prominent signs of cerebral dysfunction include headache, hyperreflexia, visual disturbances, confusion and/or altered state of consciousness. Patients usually recover completely however some patients remain disabled due to cerebrovascular damage. Intracerebral and subarachnoidal hemorrhage are severe however rare complications of eclampsia. TCD investigations regularly find vasospasm in all great cerebral arteries. Reversible hypodense lesions in the white matter on early CT-scans and increased signal intensities on T2-weighted MRT images indicate local edema. The etiology of preeclampsia and eclampsia remains unknown and its current pathophysiology is still hypothetical. The clinical picture may best be explained by an endothelial dysfunction with increased vascular sensitivity to circulating pressure agents as well as by a structural endothelial lesion with fluid loss from the intravascular compartment.