Author:
Wikeley Sarah,Bacon Imogen,Greer Orene,Evans Matthew,Hasan Rizwan,Pathak Sangeeta
Abstract
This case report describes a woman who developed involuntary, uncoordinated movements of her face and limbs following a spontaneous vaginal delivery, complicated by postpartum haemorrhage. Using systematic assessment with multidisciplinary team input, a differential diagnosis was proposed and relevant investigations were undertaken. Atypical eclamptic or generalised seizures were excluded clinically and neuroimaging ruled out an intracranial vascular event such as stroke or venous sinus thrombosis. Local anaesthetic systemic toxicity was managed empirically with intravenous lipid emulsion and intravenous fluids. A diagnosis of drug-induced dyskinesia was made, most likely secondary to ondansetron, with which dystonias and myoclonus have been described. This woman’s symptoms were transient and resolved within 2 hours.This case presented a complex differential diagnosis, highlighting the paucity of guidance available. We propose a diagnostic algorithm to aid in the identification of acute involuntary movements in pregnancy and the puerperium.
Reference55 articles.
1. New-onset epilepsy in women with first time seizures during pregnancy;Ma;Seizure,2020
2. Li W , Hao N , Xiao Y , et al . Clinical characteristics and pregnancy outcomes of new onset epilepsy during pregnancy. Medicine 2019;98:e16156. doi:10.1097/MD.0000000000016156
3. Diehl B , Sisodiya SM , Manford M . Frontal lobe epilepsy. In: Rugg-Gunn F , Smalls J , eds. From channels to commissioning - a practical guide to epilepsy. Epilepsy Society, 2015. Available: https://epilepsysociety.org.uk/epilepsy-teaching-weekend-2015 [accessed 8 Dec 2023].
4. Diagnosis of DWI-negative acute ischemic stroke
5. Lees AJ . ODD AND UNUSUAL MOVEMENT DISORDERS, Available: www.jnnp.com [Accessed 10 Apr 2022].
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
1. Ondansetron;Reactions Weekly;2024-01-27