Spectrum of neurological disorders in pregnancy in a neurology clinic in eastern Uttar Pradesh

Authors

  • Pavan Kumar Singh Director, Shikhar Neuro Clinic and Research Centre, Gorakhpur, Uttar Pradesh, India
  • Reeta Singh Department of Obsterics and Gynecology, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20213837

Keywords:

MRA, Carpal tunnel syndrome, Nerve conduction study, Benign intracranial hypertension, Posterior reversible encephalopahy syndrome

Abstract

Background: Pregnancy-induced endocrinal and physiological changes increase the risk of neuropathy and musculoskeletal problems in pregnancy. The purpose of this study is to provide a comprehensive look at the neurological and musculoskeletal disorders occurring during pregnancy.

Methods: A total of 202 antenatal women with neurological and musculoskeletal problems were enrolled for study. Their demographic characteristics were noted. Detailed clinical history and neurological examination was done. Radiological investigations including x-ray, CT head, MRI brain, MRA, MR Venography with electrophysiological NCS studies were performed accordingly.

Results: Among musculoskeletal symptoms most prevalent was LBA (50%), cramps (15.7 %) followed by pelvic girdle pain (10%) and wrist pain (8,5). Among peripheral neurological disorders most common was CTS (12.37%) followed by bells palsy. Among Central neurological disorders most common was headache (26.23%), seizures (12.37%), eclampsia (2.47%), followed by Cortical venous thrombosis CVT, BIH, PRES.

Conclusions: Among musculoskeletal complaints the most frequent symptoms during pregnancy were low back pain, hip joint pain, cramps and wrist pain. Among neuropathies CTS prevalence was relatively higher in pregnant women especially in third trimester and was mostly bilateral. Among central neurological symptoms headache especially migraine without aura and seizures were common while eclampsia, CVT, BIH, PRES were less common.

References

Sacco S, Ricci S, Degan D, Carolei A. Migraine in women: the role of hormones and their impact on vascular diseases. J Headache Pain. 2012;13(03):177-89.

Karlı N, Baykan B, Ertaş M. Turkish Headache Prevalence Study Group. Impact of sex hormonal changes on tension-type headache and migraine: a cross-sectional population-based survey in 2,600 women. J Headache Pain. 2012;13(07):557-65.

Zyluk A. Carpal tunnel syndrome in pregnancy: a review. Pol Orthop Traumatol. 2013;78:223-7.

Monini S, Lazzarino AI, Iacolucci C, Buffoni A, Barbara M. Epidemiology of Bell’s palsy in an Italian Health District: incidence and case-control study. Acta Otorhinolaryngol Ital. 2010;30(04):198.

Martins RF, Silva JLP. Back pain is a major problem for many pregnant women. Rev Assoc Med Bras. 2005;51(3):144-7.

Kristiansson P, Svardsudd K, Von Schoultz B. Serum relaxin, symphyseal pain, and back pain during pregnancy. Am J Obstet Gynecol. 1996;175:1342-47.

Ramachandra P, Maiya AG, Kumar P, Kamath A. Prevalence of musculoskeletal dysfunctions among Indian pregnant women. J. Pregnancy. 2015;437105.

Smagulova IE, Sharmanov T. Assessment of nutritional status of pregnant women living in Аstana. J Clin Med Kaz. 2014;2(32):38-42.

Hammar M, Larsson L, Tegler L. Calcium treatment of leg cramps in pregnancy. Effect on clinical symptoms and total serum and ianized serum calcium concentrations. Acta Obstet Gynec Scand. 1981;60:345-7.

Stolp-Smith KA, Pascoe MK, Ogburn PL Jr. Carpal tunnel syndrome in pregnancy: frequency, severity, and prognosis. Arch Phys Med Rehabil. 1998;79:1285-7.

Padua L, Aprile I, Caliandro P. Symptoms and neurophysiological picture of carpal tunnel syndrome in pregnancy. Clin Neurophysiol. 2001;112:1946-51.

Pazzaglia CC. Multicenter study on carpal tunnel syndrome and pregnancy and natural course. Asta Neuro Chir Suppl. 2005;92:35-9.

Khosrawi S, Maghrouri R. The prevalence and severity of carpal tunnel syndrome during pregnancy. Adv Biomed Res. 2012;1:43.

Meems M, Truijens S, Spek V, Visser LH, Pop VJ. Prevalence, course and determinants of carpal tunnel syndrome symptoms during pregnancy: a prospective study. BJOG. 2015;122(08):1112-8.

Padua L, Di Pasquale A, Pazzaglia C, Liotta GA, Librante A, Mondelli M. Systematic review of pregnancy-related carpal tunnel syndrome. Muscle Nerve. 2010;42(05):697-702.

Padua L, Aprile I, Caliandro P. Symptoms and neurophysiological picture of carpal tunnel syndrome in pregnancy. Clin Neurophysiol. 2001;112:1946-51.

Baumann F, Karlikaya G, Yuksel G. The subclinical incidence of CTS in pregnancy: assessment of median nerve impairment in asymptomatic pregnant women. Neurol Neurophysiol Neurosci. 2007;3.

Ekman-Ordeberg G, Sälgeback S, Ordeberg G. Carpal tunnel syndrome in pregnancy. A prospective study. Acta Obstet Gynecol Scand. 1987;66:233-5.

Robbins MS, Farmakidis C, Dayal AK, Lipton RB. Acute headache diagnosis in pregnant women: a hospital-based study. Neurol. 2015;85(12):1024-30.

Turner DP, Smitherman TA, Eisenach JC, Penzien DB, Houle TT. Predictors of headache before, during, and after pregnancy: a cohort study. Headache. 2012;52(03):348-62.

Facchinetti F, Allais G, Nappi RE, et al. Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalalgia. 2009;29(03):286-92.

Contag SA, Mertz HL, Bushnell CD. Migraine during pregnancy: is it more than a headache? Nat Rev Neurol. 2009;5(08):449-56.

Sacco S, Ricci S, Degan D, Carolei A. Migraine in women: the role of hormones and their impact on vascular diseases. J Headache Pain. 2012;13(03):177-89.

Karlı N, Baykan B, Ertaş M, et al; Turkish Headache Prevalence Study Group. Impact of sex hormonal changes on tension-type headache and migraine: a cross-sectional population-based survey in 2,600 women. J Headache Pain. 2012;13(07):557-65.

Meng R, Ji X, Wang X, Ding Y. The etiologies of new cases of cerebral venous sinus thrombosis . Intractable Rare Dis Res. 2012;1(01):23-6.

Cantu-Brito C, Arauz A, Aburto Y, Barinagarrementeria F, RuizSandoval JL, Baizabal-Carvallo JF. Cerebrovascular complications during pregnancy and postpartum: clinical and prognosis observations in 240 Hispanic women. Eur J Neurol. 2011;18(06):819-25.

Edlow JA, Caplan LR, O’Brien K, Tibbles CD. Diagnosis of acute neurological emergencies in pregnant and post-partum women. Lancet Neurol. 2013;12(02):175-85.

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Published

2021-09-27

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Original Research Articles