Unexplained fitting in three parturients suffering from postdural puncture headache

We present the cases of three women who, within a 6‐month period, suffered post‐partum generalized tonic–clonic seizures. All had received an epidural in labour for analgesia and were subsequently diagnosed as suffering from postdural puncture headache. All were treated for that headache with Synact...

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Bibliographic Details
Published inBritish journal of anaesthesia : BJA Vol. 89; no. 5; pp. 782 - 785
Main Authors Oliver, C. D., White, S. A.
Format Journal Article
LanguageEnglish
Published Oxford Oxford University Press 01.11.2002
Oxford Publishing Limited (England)
Subjects
Adult
Analgesia, Epidural - adverse effects
Anesthesia
Anesthesia, Obstetrical - adverse effects
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
complications
convulsions
Cosyntropin - therapeutic use
Female
Headache - drug therapy
Headache - etiology
Humans
Key words: anaesthesia
Local anesthesia. Pain (treatment)
Medical sciences
obstetric
pharmacology
postdural puncture headache
Seizures - etiology
Spinal Puncture - adverse effects
sumatriptan
Sumatriptan - therapeutic use
Synacthen
anaesthesia, obstetric; complications, convulsions; complications, postdural puncture headache; pharmacology, sumatriptan; pharmacology, Synacthen
Headache
Agonist
Sumatriptan
Toxicity
5-HT1 Serotonine receptor
Labor
Puerperal disorders
Pain
pharmacology, sumatriptan
Complication
Female
Neurological disorder
Corticotropin
Human
Nervous system diseases
pharmacology, Synacthen
anaesthesia, obstetric
Puerperium
Case study
Pregnancy
Analgesia
complications, postdural puncture headache
Chemotherapy
Treatment
Convulsion
Extradural administration
complications, convulsions
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Summary:We present the cases of three women who, within a 6‐month period, suffered post‐partum generalized tonic–clonic seizures. All had received an epidural in labour for analgesia and were subsequently diagnosed as suffering from postdural puncture headache. All were treated for that headache with Synacthen and one also received sumatriptan before her seizures. All made satisfactory recoveries and were discharged home. None displayed classical patterns suggestive of pre‐eclampsia, meningitis, cortical venous thrombosis or any other pathological process that might explain these events adequately, and the specific precipitating factors were left unidentified. Br J Anaesth 2002; 89: 782–5
Bibliography:istex:9201777D0B3E68D3E2C338D462D90868FAD28344
local:aef265
Accepted for publication: June 17, 2002
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ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
ObjectType-Article-3
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/89.5.782