II. Definitions
- Eclampsia ("sudden flash" or "shining forth")
- Most severe form of PIH characterized by Seizures
- Also referred to as Toxemia or "toxin present"
III. Epidemiology
IV. Pathophysiology
- Results from focal cerebral edema
- Associated with transient Vasoconstriction and ischemia
- Usually results from progressive Severe Preeclampsia
- May also occur with little warning
- Mild Preeclampsia may precede Eclamptic Seizure
-
Blood Pressure is only mildly increased in 30-60% of patients
- Up to 15% of cases have diastolic BP <90 mmHg
V. Signs
- See Preeclampsia
- Phase 0: Preceding symptoms
- Headache (80%)
- Visual changes (45%)
- Phase 1: Prodrome (brief)
- Twitching
- Facial congestion
- Mouth foaming
- Altered Level of Consciousness
- Phase 2: Tonic
- Muscle rigidity
- Phase 3: Seizure activity for 1 to 1.5 minutes
- May occur without preceding neurologic symptoms (e.g. Headache) in up to 20% of patients
- Rhythmic Muscle Contractions and relaxation
- Generalized Tonic Clonic Seizure (or multifocal or Focal Seizure)
- Loss of respiratory activity
- Fetal Bradycardia
- Phase 4: Comatose
- Respiratory effort, but otherwise comatose
- Phase 5: Post-ictal
- Confused and agitated, combative
VI. Diagnosis: Eclampsia
- New onset Generalized Tonic Clonic Seizure, multifocal or Focal Seizure AND
- Pregnant or postpartum (within 6 weeks) AND
- Hypertensive Disorder in Pregnancy AND
- No alternative diagnosis for Seizure
VII. Differential Diagnosis
- See Seizure Causes
VIII. Management
IX. References
- Fontaine (2000) in ALSO, B:1-36
- Sibai in Gabbe (2002) Obstetrics, p. 945-74
- (2000) Am J Obstet Gynecol 183(1):S1-22 [PubMed]
- Farahi (2024) Am Fam Physician 109(3): 251-60 [PubMed]
- Leeman (2016) Am Fam Physician 93(2):121-7 [PubMed]
- Zamorski (2001) Clin Fam Pract 3:329-47 [PubMed]
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Related Studies
| Definition (NCI) | A potentially life-threatening pregnancy-related disorder characterized by tonic-clonic seizures in association with hypertension after the twentieth week of gestation and up to six weeks postpartum and in the absence of other potential causes of seizures.(NICHD) |
| Definition (MSH) | Onset of HYPERREFLEXIA; SEIZURES; or COMA in a previously diagnosed pre-eclamptic patient (PRE-ECLAMPSIA). |
| Definition (CSP) | convulsions and coma occurring in pregnant or puerperal women, associated with hypertension, edema, and proteinuria. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D004461 |
| ICD10 | O15 , O15.9 |
| SnomedCT | 156111007, 198996001, 198989003, 198988006, 15938005 |
| English | Eclampsia, Eclampsias, ECLAMPSIA, Eclampsia unspecified, Eclampsia, unspecified as to time period, eclampsia (diagnosis), eclampsia, Eclampsia NOS, Eclampsia [Disease/Finding], Eclampsia unspecified (disorder), Eclampsia NOS (disorder), Eclamptic toxemia, Toxemia with convulsions, Eclamptic toxaemia, Toxaemia with convulsions, Eclampsia (disorder), eclamptic; toxemia, toxemia; eclamptic |
| French | ECLAMPSIE, Eclampsie, Éclampsie |
| Portuguese | ECLAMPSIA, Eclampsia |
| Spanish | ECLAMPSIA, eclampsia, SAI (trastorno), eclampsia, no especificada, eclampsia, SAI, eclampsia, no especificada (trastorno), eclampsia (trastorno), eclampsia, toxemia con convulsiones, toxemia eclámpsica, Eclampsia |
| German | EKLAMPSIE, Eklampsie, bei der der zeitliche Bezug nicht angegeben ist, Eklampsie |
| Japanese | 子癇, ｼｶﾝ |
| Swedish | Graviditetskramp |
| Czech | eklampsie, Eklampsie |
| Finnish | Eklampsia |
| Russian | EKLAMPSIIA, ЭКЛАМПСИЯ |
| Korean | 자간증, 시기 상세불명의 자간증 |
| Croatian | EKLAMPSIJA |
| Polish | Drgawki rzucawkowe, Rzucawka porodowa |
| Hungarian | Eclampsia |
| Norwegian | Svangerskapskrampe, Eclampsia gravidarum, Eklampsi |
| Dutch | eclamptisch; toxemie, toxemie; eclamptisch, Eclampsie, niet gespecificeerd naar tijdperk, eclampsie, Eclampsie |
| Italian | Eclampsia |
Ontology: Eclamptic seizure (C0743381)
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 426634003 |
| English | Eclamptic seizure (finding), Eclamptic fit, Eclamptic seizure |
| Spanish | convulsión eclámptica (hallazgo), convulsión eclámptica |
