Clinical Analysis Of 12 Cases Of Eclampsia Complicated With Reversible Encephalopathy Syndrome In Posterior Brain

[Objective]To investigate the clinical features,imaging features,treatment and prognosis of severe preeclampsia and eclampsia combined with reversible encephalopathy syndrome(PRES).[Methods]A total of 12 patients with severe pre-eclampsia and eclampsia combined with reversible encephalopathy syndrome(PRES)admitted to the intensive medicine department of the First Affiliated Hospital of Kunming Medical University from August 2010 to August 2017 were reviewed.The clinical manifestations and imaging features of eclampsia combined with PRES were reviewed,and the etiology,pathophysiology,imaging characteristics,treatment and prognosis of the disease were described in detail by reviewing the literature.[Results]There were 12 patients,including 3 cases of severe preeclampsia,and 9 cases of eclampsia(including 6 cases of preeclampsia and 3 cases of postpartum eclampsia),all of which were acute onset.Severe preeclampsia and eclampsia combined with reversible encephalopathy in the back of the brain(Posterior reversible encephalopathy syndrome)are mainly clinical manifestations of headache,visual disturbances,and changes in mental status.Cerebral CT showed more bilateral symmetrical parietal-occipital(occipitotemporal)lobe,basal ganglia low density lesions.MRI mostly prompted the bilateral frontotemporal occipital lobe symmetric white matter multiple lesions,mainly to the parietal-occipital(occipital)lobe.All patients received symptomatic and supportive treatments such as sedation,analgesia spasmolysis,control of blood pressure,and dehydration and control of intracranial pressure.Patients with severe preeclampsia and prenatal eclampsia were terminated in a timely manner.The clinical symptoms of all patients improved,and most of the patients had better imaging results.there was only one patient with postpartum eclampsia remained a left homonymous hemianopsia.[conclusion]1.In this study,12 patients underwent lactate dehydrogenase(LDH)examination,and 11 patients showed high elevation,suggesting that lactate dehydrogenase may have important significance in the diagnosis of severe preeclampsia/eclampsia combined with PRES.2.Severe preeclampsia and imaging of eclampsia mostly manifested as bilateral symmetric posterior multiple white matter lesions,showing reversibility.The lesions were mainly occipital lobe,parietal lobe,and temporal lobe.They were also found in the frontal lobe,basal ganglia region,and brain stem region.3.Patients were admitted to the hospital to receive sedation,analgesia spasmolysis,control of blood pressure,dehydration and control of intracranial pressure,timely termination of pregnancy and other symptomatic and supportive care.After treatment,the clinical symptoms of patients improved and imaging examinations showed that the lesions in the brain were reduced and disappeared,and the prognosis was good.