Abstract
A case of the late postpartum convulsion due to highly similar mechanisms on "late postpartum eclampsia" without toxemia of pregnancy is reported. A 30-year-old female in 5 days after delivery was admitted due to a suddenly developed generalized clonic convulsion after headache with scintillating scotoma. On admission, she had hypertension without any neurological deficits. On day 0 CT scans showed a low-density lesion in the left occipital subcortical area. On day 10 MR-images(MRI)revealed hyperintensity on T2-weighted images in the same area. MR-angiograms(MRA)on day 10 and cerebral angiograms on day 13 demonstrated multi-local vasospasm in the bilateral main arterial trunks of the anterior and posterior circulations. On a satisfactory course the patient was discharged without sequelae 3 weeks after the attack. All the abnormal findings disappered on MRI and MRA 7 weeks after the attack. Convulsions with initial presentation more than 48 hours but less than 4 weeks after delivery with toxemia of pregnancy are referred to as "late postpartum eclampsia". In our case, the late postpartum convulsion without toxemia suggested occurring in the highly similar mechanisms on "eclampsia", because of the convulsion with hypertension after the prodromal symptoms, the reversible multiple cerebral vasospasms, and no other systemic diseases. We emphasize that closer attention to these prodromal symptoms can prevent postpartum women, even in the absence of antecedent preeclampsia, from this entity.
