Reversible Cerebral Vasoconstriction Syndrome Mimicking Eclampsia

Chalothorn Wannaphut; Yoshito Nishimura; Weiming Du; Chutawat Kookanok; Travis Watai; Christina Chong

doi:10.7759/cureus.57021

Reversible Cerebral Vasoconstriction Syndrome Mimicking Eclampsia

Cureus. 2024 Mar 27;16(3):e57021. doi: 10.7759/cureus.57021. eCollection 2024 Mar.

Authors

Chalothorn Wannaphut¹, Yoshito Nishimura¹, Weiming Du¹, Chutawat Kookanok², Travis Watai¹, Christina Chong¹

Affiliations

¹ Internal Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, USA.
² Internal Medicine, Phramongkutklao College of Medicine, Mahidol University, Bangkok, THA.

Abstract

This report describes the case of an 18-year-old Micronesian pregnant woman at 32 weeks gestation, initially presumed to have eclampsia but later diagnosed with reversible cerebral vasoconstriction syndrome (RCVS). She presented with seizures, altered mental status, nystagmus, lower extremity weakness, and absent reflexes. An extensive workup ruled out infectious and autoimmune causes, but a computed tomography angiogram (CTA) revealed severe cerebral vasoconstriction. Treatment included levetiracetam, intravenous magnesium, and nimodipine. The case highlights the challenge of differentiating RCVS from eclampsia in the postpartum period, emphasizing the importance of considering alternative diagnoses and brain CTA when RCVS is suspected, with calcium channel blockers potentially contributing to favorable neurological outcomes.

Keywords: call fleming syndrome; eclampsia; postpartum; rcvs; reversible cerebral vasoconstriction syndrome.

Publication types

Case Reports