Differential diagnosis for seizures during childbirth
What is the differential diagnosis for seizures during childbirth?
Eclampsia , HELLP syndrome , and TTP are the most commonly observed causes for seizures during the third trimester.
Amniotic fluid embolism ,
water intoxication ,
autonomic stress in patients with upper spinal cord injury
toxicity from local anesthetics are all intrapartum causes for seizures.
Cerebral venous thrombosis usually occurs postpartum and may present with seizures.
Subarachnoid hemorrhage may occur at any time during pregnancy and may produce seizures, although aneurysms most commonly rupture during the third trimester, with greatest risk for rebleeding in the postpartum period.
Arteriovenous malformations are more likely to rupture in the second trimester and rebleed during delivery or with subsequent pregnancies.
Epilepsy may manifest at any time before, during, or after pregnancy and may require lifelong therapy.
However, such patients must be distinguished from those with gestational epilepsy , which requires therapy only during pregnancy.
