[Seizures in pregnancy: not always eclamptic seizures]

The differential diagnosis of seizures during pregnancy is extensive and includes potentially fatal underlying diagnoses. Both pregnancy and non-pregnancy related aetiologies should be considered.

A 38-years old pregnant woman presented to the emergency department at 31 weeks and 5 days with generalized tonic-clonic seizures. Initial an eclamptic seizure was suspected. Because the seizures lasted despite treatment with magnesium sulphate and anti-epileptic medication. Imaging of the head was performed and a brain tumour was suspected and a biopsy revealed the presence of a high-grade glioma. At 37 weeks of gestation, labour was induced and the patient delivered a healthy daughter. The patient was then palliatively treated with antiepileptic drugs and chemotherapy.

Structural brain changes caused by a high-grade gliomas represent a rare cause of seizure during pregnancy, emphasizing the importance of considering non-obstetric causes of seizures in pregnant women.