# Reversible Cerebral Vasoconstriction Syndrome Mimicking Eclampsia

## TL;DR

A pregnant woman initially thought to have eclampsia was later diagnosed with a rare condition called reversible cerebral vasoconstriction syndrome.

## Contribution

The case highlights the diagnostic challenge of distinguishing RCVS from eclampsia and the potential role of calcium channel blockers in treatment.

## Key findings

- The patient's symptoms and CTA findings led to a diagnosis of RCVS, not eclampsia.
- Treatment with levetiracetam, magnesium, and nimodipine resulted in favorable neurological outcomes.
- The case underscores the need to consider RCVS in the differential diagnosis of postpartum neurological symptoms.

## Abstract

This report describes the case of an 18-year-old Micronesian pregnant woman at 32 weeks gestation, initially presumed to have eclampsia but later diagnosed with reversible cerebral vasoconstriction syndrome (RCVS). She presented with seizures, altered mental status, nystagmus, lower extremity weakness, and absent reflexes. An extensive workup ruled out infectious and autoimmune causes, but a computed tomography angiogram (CTA) revealed severe cerebral vasoconstriction. Treatment included levetiracetam, intravenous magnesium, and nimodipine. The case highlights the challenge of differentiating RCVS from eclampsia in the postpartum period, emphasizing the importance of considering alternative diagnoses and brain CTA when RCVS is suspected, with calcium channel blockers potentially contributing to favorable neurological outcomes.