[Reversible multifocal encephalopathy in fulminant eclampsia]

Fulminant eclampsia characterised by the onset of focal neurological signs and convulsions is a rare complication of normal pregnancy in the third trimenon. We report on eight women (22-35 years old) with fulminant eclampsia who were admitted to our hospital due to seizures and central pareses. The patients presented with multifocal lesions involving grey and white matter preferentially of the occipital lobes, as evidenced by neuroimaging. Transcranial Doppler sonography revealed increased cerebral blood flow velocities. Treatment consisted of antihypertensive and anticonvulsive medication and operative termination of pregnancy. The patients normalised within 14 days. Our data show that fulminant eclampsia can induce a severe multifocal encephalopathy that can be reversible when treatment and termination of pregnancy are initiated immediately.