ABSTRACT
Epilepsy affects about 0.5% of women of childbearing age and is the commonest chronic neurological disorder to complicate pregnancy. Epilepsy is classified according to the clinical type of seizure or specific electroencephalographic features. Pointers to a diagnosis of primary generalized epilepsy are myoclonic jerks and photosensitivity. The risks of arterial ischaemic stroke, cerebral venous thrombosis and intracranial haemorrhage are increased, particularly in the puerperium. MRI shows characteristic bilateral involvement of white and grey matter in the posterior regions of the cerebral hemispheres. Magnetic resonance angiography shows multifocal, segmental constriction of large- and medium-sized cerebral arteries, giving a characteristic ‘beading’ appearance. Ramsay Hunt syndrome is herpes zoster (shingles) of the geniculate ganglion and causes a unilateral facial palsy (identical to Bell's) with herpetic vesicles in the external auditory meatus and occasionally the soft palate. Reproduction of symptoms on percussion over the carpal tunnel (Tinel's sign) or sustained flexion of the wrist (Phalen's sign).
