Differential Diagnosis for New Onset Seizure in Pregnancy
Single Most Likely Diagnosis
- Eclampsia: This is the most likely diagnosis due to the high incidence of eclampsia in pregnant women, which is characterized by new-onset seizures in the presence of preeclampsia. The condition is a leading cause of maternal and fetal morbidity and mortality.
Other Likely Diagnoses
- Preeclampsia with severe features: While not as directly associated with seizures as eclampsia, preeclampsia with severe features can lead to complications that increase the risk of seizures.
- Pre-existing epilepsy: Women with a history of epilepsy are at risk of seizure recurrence during pregnancy, especially if their medication levels are not adequately monitored and adjusted.
- Stroke or cerebral venous thrombosis: Pregnancy increases the risk of thromboembolic events, including stroke and cerebral venous thrombosis, which can present with seizures.
Do Not Miss Diagnoses
- Intracranial hemorrhage: Although less common, intracranial hemorrhage is a critical and potentially life-threatening condition that requires immediate diagnosis and treatment.
- Meningitis or encephalitis: Infections of the central nervous system can present with seizures and have significant morbidity and mortality if not promptly treated.
- Hypertensive encephalopathy: This condition, characterized by high blood pressure leading to brain dysfunction, can cause seizures and is critical to diagnose and manage to prevent further complications.
Rare Diagnoses
- Arteriovenous malformation (AVM) or arteriovenous fistula (AVF): These vascular abnormalities can cause seizures due to bleeding or mass effect and are important to identify due to their potential for serious complications.
- Brain tumors: Although rare, new-onset seizures during pregnancy can be the presenting symptom of a brain tumor, making imaging studies crucial in the diagnostic workup.
- Reversible cerebral vasoconstriction syndrome (RCVS): This rare condition, characterized by temporary narrowing of the blood vessels in the brain, can cause seizures and is often associated with pregnancy and the postpartum period.