Status Epilepticus and Low-Grade Glioma in the Pregnant State: Case Report and Ethical Considerations.
Document Type
Article
Publication Date
7-17-2024
Publication Title
Case Reports in Neurology
Abstract
INTRODUCTION: The pregnant state may cause or exacerbate existing neurological disease. Gliomas appear to be influenced by the physiological changes that occur during pregnancy. The pregnant state may also cause seizures, including status epilepticus. There are currently no defined treatment guidelines to direct clinical decision making, and many of the commonly employed therapies are contraindicated during pregnancy.
CASE PRESENTATION: The current article describes the case of a 40-year-old G3P1101 female at 10 weeks' gestation, who sought medical care for recurrent left hemifacial twitching, eventually leading to nonconvulsive status epilepticus. Intubation and sedation were required to achieve seizure cessation. Imaging revealed a lobulated cystic mass in the right parietal lobe, suspicious for low-grade glioma. Despite thorough explanation of the potential risks, the patient adamantly wished to pursue surgical intervention. An uneventful craniotomy was performed for resection of a low-grade glioma. No patient or fetal complications were encountered, and the patient has not had any reported seizures since surgery.
DISCUSSION: Managing complex neurosurgical diseases in pregnant patients provides both clinical and ethical quandaries. We describe the successful management of a patient presenting with status epilepticus caused by an underlying glioma during pregnancy. Although challenging, favorable neurosurgical outcomes are possible during pregnancy.
Volume
16
Issue
1
First Page
196
Last Page
203
Recommended Citation
Waack AL, Lucarelli VM, Marellapudi A, Gega A, Zillgitt AJ, Staudt MD. Status epilepticus and low-grade glioma in the pregnant state: case report and ethical considerations. Case Rep Neurol. 2024 Jul 17;16(1):196-203. doi: 10.1159/000539510. PMID: 39145135.
DOI
10.1159/000539510
ISSN
1662-680X
PubMed ID
39145135