Atypical Post Partum Eclampsia and Posterior Reversible Encephalopathy Syndrome

Pregnancy induced Hypertension also called as “Gestosis” plural “Gestoses” has a heterogeneous
etiology. A case of atypical eclampsia with seizures in the postpartum, that required intravenous
Magnesium sulphate is described. The two proposed theories of etiopathogeniesis of cerebral edema,
“Vasogenic Theory” and “Cytotoxic theory” are discussed. The concept of “delta hypertension” is
emphasized. Impaired fluid mobilization, decreased sodium excretion and imbalance between
angiopoietic factors in the post partum period is discussed as the likely cause of post partum
eclampsia. It can be concluded that it is important to monitor blood pressure in the postpartum state.
The patients of atypical postpartum eclampsia with PRES, are likely explained by hyper dynamic
circulation, delta hypertension and vasogenic theory. PRES is reversible, has classical clinicoradiological
features in MRI and has good prognosis with treatment.