Eclampsia with RCVS: Postpartum seizure provoked by methergine

Gregory W. Kirschen*, Katerina Hoyt, Emily Johnson, Silka Patel

*Corresponding author for this work

Research output: Contribution to journalLetterpeer-review

1 Scopus citations


Background: Eclampsia is a pregnancy complication characterized by generalized tonic-clonic convulsions. Not all seizures in pregnancy are eclamptic, and other causes include epilepsy, infection, stroke, tumor, and ruptured aneurysm. Case: A 19-year-old G1P0 presented in labor at term. She had a generalized tonic-clonic seizure one hour after vaginal delivery for which she received methergine for uterine atony. Seizure activity resolved with lorazepam and magnesium sulfate for presumed eclampsia. Brain imaging revealed vasoconstriction of the left posterior cerebral artery and blood in the subarachnoid space, and she was diagnosed with eclampsia with reversible cerebral vasoconstrictive syndrome (RCVS). Conclusion: RCVS is a pregnancy-related cause of seizure that should remain on the differential for any patient presenting with a seizure in the peripartum period, especially with use of vasoconstrictive agents. Management is controversial but involves calcium channel blockers and magnesium sulfate, as well as avoidance of vasoconstrictive agents.

Original languageEnglish (US)
Pages (from-to)131-133
Number of pages3
JournalPregnancy Hypertension
StatePublished - Mar 2022


  • Blood pressure
  • Hypertension
  • Methergine
  • Pregnancy
  • Vasoconstriction

ASJC Scopus subject areas

  • Internal Medicine
  • Obstetrics and Gynecology


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