Neurology of pregnancy

Area of Science:

• Neurology
• Obstetrics
• Maternal-Fetal Medicine

Background:

• Pregnancy induces significant physiological changes in women, increasing susceptibility to specific neurological disorders.
• Neurological conditions during pregnancy range from vascular events to inflammatory and neuromuscular disorders, presenting diagnostic and management challenges.

Purpose of the Study:

• To review the unique neurological disorders that arise during pregnancy.
• To discuss the pathophysiology, clinical presentations, and management of pregnancy-associated neurological conditions.
• To highlight the impact of pregnancy on pre-existing neurological diseases and the safety of treatments.

Main Methods:

• Literature review of neurological disorders in pregnancy.
• Analysis of shared pathophysiological mechanisms, particularly vascular endothelial dysfunction.
• Discussion of clinical manifestations and management strategies for various neurological conditions during gestation.

Main Results:

• Vascular disorders (pre-eclampsia, stroke, RCVS, PRES, thunderclap headache) often stem from endothelial dysfunction.
• Pregnancy can improve Multiple Sclerosis but may exacerbate or present new conditions like compression neuropathies and myasthenia gravis.
• Epilepsy's course is generally unaffected, but some antiepileptic drugs pose risks for fetal malformations; brain tumors may grow during pregnancy.

Conclusions:

• Pregnancy-associated neurological disorders are diverse, with many sharing vascular origins.
• Management requires careful consideration of maternal and fetal well-being, including treatment safety.
• Further research is needed to optimize care for pregnant individuals with neurological conditions.