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HELLP syndrome with reversible posterior leukoencephalopathy.

E Marano1, N Scuteri, G Vacca

  • 1Departments of Neurological Sciences, Federico II University of Naples, Via S. Pansini 5, I-80131 Naples, Italy.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|June 27, 2003
PubMed
Summary

A triplet pregnancy following artificial insemination led to a seizure and HELLP syndrome in a 30-year-old woman. Neurological abnormalities resolved within six months.

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Area of Science:

  • Obstetrics and Gynecology
  • Neurology
  • Reproductive Medicine

Background:

  • Triplet pregnancies, while rare, present unique maternal and fetal risks.
  • Assisted reproductive technologies, such as artificial insemination, increase the likelihood of multiple gestations.
  • HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets) is a severe form of preeclampsia.

Observation:

  • A 30-year-old primipara experienced a generalized tonic-clonic seizure during the eighth month of a triplet pregnancy conceived via artificial insemination.
  • Blood chemistry results at the time of seizure were consistent with HELLP syndrome.
  • Cerebral Magnetic Resonance Imaging (MRI) and Electroencephalography (EEG) showed abnormalities immediately post-seizure.

Findings:

  • The patient presented with a rare combination of triplet pregnancy, HELLP syndrome, and eclamptic seizure.

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  • Neurological deficits indicated acute cerebral involvement secondary to the hypertensive disorder.
  • Prompt medical management was initiated following the seizure and diagnosis of HELLP syndrome.

    • Implications:

    • This case highlights the critical need for vigilant monitoring of high-risk pregnancies, particularly those involving assisted reproduction.
    • Early recognition and management of HELLP syndrome and its neurological complications are crucial for maternal outcomes.
    • The transient nature of the observed MRI and EEG changes suggests potential for neurological recovery with timely intervention.