Neurological complications of eclampsia.

OBJECTIVE: A prospective study was conducted to evaluate the various neurological (clinical, radiological and EEG) complications in patients of eclampsia. METHODS: Thirty nine patients of eclampsia were studied regarding neurological findings at presentation and electroencephalographic (EEG) tracings were recorded in each patient. Patients with an abnormal neurologic examination and/or focal or lateralizing findings on EEG, underwent a CT scan (n = 18). Foetal and maternal outcome were recorded. RESULTS: The age of the patients ranged from 19-30 (mean +/- SD, 24.2 +/- 3.5) years thirty six patients (92%) had seizures in the antenatal period, 2 (5.4%) patients developed post partum eclampsia and 1 (2.6%) patient had seizures before and after delivery. A diffuse encephalopathy was seen in 9 patients (23.1%), 4 patients (10.2%) had hemiparesis and 1 patient (2.6%) had papilledema. EEG abnormalities were seen in 29 cases (74%) and included generalized slowing (n = 19), generalized sharp waves (n = 9), focal slowing (n = 4), focal sharp waves (n = 2) and spikes (generalized and focal) were seen in 1 patient each. Abnormal CT scan was seen in 10 cases (n = 18). Five patients had generalized infarct was seen in 1 patient each. There were 8 (20.5%) still births and 31 (19.5%) live births and no maternal mortality. CONCLUSIONS: Antenatal seizures occur in > 90% cases of eclampsia and less than 10% cases have seizures after delivery. A diffuse encephalopathy is the commonest clinical abnormality along with generalized slowing on EEG. Although cerebral oedema is common focal infarcts may be seen on CT scan.

Auditory function after lumbar puncture.

This study was undertaken to evaluate the incidence and degree of hearing loss by clinical and audiometric analysis after lumbar puncture and to determine the site of involvement in brainstem auditory evoked response (BAER) studies. We also wanted to determine whether the degree of hearing loss is related to the size of the spinal needle used. Twenty patients were randomised for lumbar puncture into 2 groups, one using 20G and the other using 24G needle. Audiometry and brainstem auditory evoked response studies were carried out before and 24 hours after lumbar puncture. There was no statistically significant change in the hearing levels (on audiometry), before and after lumbar puncture, in cases belonging to both the groups (20G and 24G). There was no statistically significant change in the latency of each wave (on BAER) before and after lumbar puncture in cases belonging to both the groups (20G and 24G). No significant change either in hearing level on audiometry or in latency of BAER waves was noted when the two groups (20G, 24G) were compared with each other. In the present study, there was no indicator to suggest that the size of the lumbar puncture needle influenced auditory function.