Reversible multifocal encephalopathy in fulminant eclampsia

Fulminant eclampsia characterised by the onset of focal neurological signs and convulsions is a rare complication of normal pregnancy in the third tri menon. We report on eight women (22-35 yea rs old) with fulminant eclampsia who were admitted to our hospital due to seizures and central pareses. The patients presented with multifocal lesions involving grey and white matter preferentially of the occipital lobes, as evidenced by neuroimaging. Trans cranial Doppler sonography revealed increased cerebral blood flow velocitie s. Treatment consisted of antihypertensive and anticonvulsive medication an d operative termination of pregnancy. The patients normalised within 14 day s. Our data show that fulminant eclampsia can induce a severe multifocal en cephalopathy that can be reversible when treatment and termination of pregn ancy are initiated immediately.