Neuropatías en el embarazo

Neuropathies in pregnancy

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Javier D. Triana
Sergio A. Salgado


Las neuropatías en el embarazo aunque no muy frecuentes, sí generan un gran impacto en la calidad de vida cuando no se establece el diagnóstico y tratamiento oportunos. Existen varios mecanismos fisiopatológicos como los de origen mecánico, hormonal e inmunológico. La localización de la lesión neuronal dependerá del mecanismo y por ende tiene relación directa con el trimestre del embarazo. Así, las neuropatías de origen hormonal y mecánico asociadas con el embarazo, como la del túnel del carpo que es la más frecuente, se presentan más en el segundo y tercer trimestre, mientras las de estricta aparición mecánica como las que comprometen los miembros inferiores, ocurren en especial durante el parto. Otras neuropatías como las craneales son infrecuentes y obligan a descartar etiologías secundarias. Las polineuropatías más que estar relacionadas con el embarazo, son precipitadas o se pueden expresar durante esta condición. La siguiente revisión narrativa describe las neuropatías más comunes durante el embarazo según la localización, sintomatología, hallazgos clínicos, trimestre de aparición y presunto origen fisiopatológico.

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1. Bromberg MB. An approach to the evaluation of peripheral neuropathies. Semin Neurol. 2010;30(4):3 0 .

2. Alport AR, Sanderv W. linical approach to peripheral neuropathy: anatomic localization and diagnostic testing. ontinuum (Minneap Minn). 2012;18(1):13 38.

3. Bromberg MB. An electrodiagnostic approach to the evaluation of peripheral neuropathies. Phys Med Rehabil lin Am. 2013;24(1):1 3 68.

4. Rezania K. euromuscular disorders in pregnancy. n: Minagar A, editor. eurological disorders and pregnancy. Amsterdam; Boston; eidelberg: Elsevier; 2011. p. 1 9 84.

5. Cernaro , ac uaniti A, upica R, Buemi A, rimboli D, Giorgianni G, et al. Rela in: new pathophysiological aspects and pharmacological perspectives for an old protein. Med Res Rev. 2014;34(1):77 10 .

6. Adams Waldorf KM, elson J . Autoimmune disease during pregnancy and the microchimerism legacy of pregnancy. mmunol nvest. 2008;37( ):631 44.

7. Gillman GS, Schaitkin BM, May M, Klein SR. Bell’s palsy in pregnancy: a study of recovery outcomes. tolaryngol ead eck Surg. 2002;126(1):26 30.

8. Katz A, Sergienko R, Dior U, Wiznitzer A, Kaplan DM, Sheiner E. Bell’s palsy during pregnancy: is it associated with adverse perinatal outcome . aryngosco pe. 2011;121(7):139 8.

9. Robinson JR, Pow JW. Bell’s palsy: a predisposition of pregnant women. Arch Otolaryngol. 1972; 9 (2):12 9.

10. Cohen , avie , Granovsky Grisaru S, Aboulafia , Diamant . Bell palsy complicating pregnancy: a review. bstet Gynecol Surv. 2000; (3):184 8.

11. Huna Baron R, Kupersmith MJ. diopathic intracranial hypertension in pregnancy. J eurol. 2002; 249(8):1078 81.

12. Digre KB, arner MW, orbett JJ. Pseudotumor cerebri and pregnancy. eurology. 1984; 34(6):721 9.

13. Massey EW, Guidon A . Peripheral neuropathies in pregnancy. ontinuum (Minneap Minn). 2014; 20(1 eurology of Pregnancy):100 14.

14. Padua , Di Pas uale A, Pazzaglia , iotta GA, ibrante A, Mondelli M. Systematic review of pregnancy related carpal tunnel syndrome. Muscle erve. 2010;42( ):697 702.

15. Graham RA. arpal tunnel syndrome: a statistical analysis of 214 cases. rthopedics. 1983; 6(10):1283 7.

16. Seror P. Pregnancy related carpal tunnel syndrome. J and Surg Br. 1998; 23(1):98 101.

17. Padua , Aprile , aliandro P, arboni , Meloni A, Massi S, et al. Symptoms and neurophysiological picture of carpal tunnel syndrome in pregnancy. lin europhysiol. 2001;112(10):1946 1.

18. Mondelli M, Rossi S, Monti E, Aprile , aliandro P, Pazzaglia , et al. Prospective study of positive factors for improvement of carpal tunnel syndrome in pregnant women. Muscle erve. 2007;36(6):778 83.

19. Guidon A , Massey EW. euromuscular disorders in pregnancy. eurol lin. 2012; 30(3): 889 911.

20. Massey EW, Stolp KA. Peripheral neuropathy in pregnancy. Phys Med Rehabil Clin Am. 2008; 19(1):149 62.

21. van Alfen , van Engelen BG. he clinical spectrum of neuralgic amyotrophy in 246 cases. Brain. 2006;129 (Pt 2):438 0.

22. Wong A, Scavone BM, Dugan S, Smith J , Prather , Ganchiff J , et al. ncidence of postpartum lumbosacral spine and lower e tremity nerve in uries. bstet Gynecol. 2003;101(2):279 88.

23. al akim M, Katir i B. Femoral mononeuropathy induced by the lithotomy position: a report of cases with a review of literature. Muscle erve. 1993;16(9):891 .

24. Brannegan R . Femoral mononeuropathy induced by lithotomy position. Muscle Nerve. 1994;17(4):466.

25. Steward JD. Focal peripheral neuropathies. 3rd ed. Philadelphia: ippincott Williams Wilkins; 2000.

26. Kitchen , Simpson J. Meralgia paresthetica. A review of 67 patients. Acta eurol Scand. 1972; 48( ): 47 .

27. Litwiller JP, Wells RE, alliwill JR, armichael SW, Warner MA. Effect of lithotomy positions on strain of the obturator and lateral femoral cutaneous nerves. Clin Anat. 2004;17(1):4 9.

28. Eltzschig K, ieberman ES, amann WR. Regional anesthesia and analgesia for labor and delivery. Engl J Med. 2003; 348(4):319 32.

29. Fast A, Shapiro D, Ducommun EJ, Friedmann W, Bouklas , Floman . owback pain in pregnancy. Spine (Phila Pa 1976). 1987;12(4):368 71.

30. Mantle MJ, Greenwood RM, urrey HL. Backache in pregnancy. Rheumatol Rehabil. 1977;16(2):9 101.

31. LaBan MM, Perrin J , atimer FR. Pregnancy and the herniated lumbar disc. Arch Phys Med Rehabil. 1983; 64(7):319 21.

32. Thein R, Burstein G, Shabshin . abor related sacral stress fracture presenting as lower limb radicular pain. rthopedics. 2009; 32(6):447.

33. Sa W, Rosenbaum RB. euromuscular disorders in pregnancy. Muscle erve. 2006;34( ): 9 71.

34. Katir i B, Wilbourn AJ, Scarberry S , Preston D . ntrapartum maternal lumbosacral ple opathy. Muscle erve. 2002;26(3):340 7.

35. Pleet AB, Massey EW. Intercostal neuralgia of pregnancy. JAMA. 1980;243(8):770.

36. Skeen MB, Eggleston M. horaconeuralgia gravidarum. Muscle erve. 1999; 22(6):779 80.12. Digre KB, arner MW, orbett JJ. Pseudotumor cerebri and pregnancy. eurology. 1984; 34(6):721 9. 37. Mendizabal JE

37. Mendizabal JE, Bassam BA. Guillain–Barré syndrome and cytomegalovirus infection during pregnancy. South Med J. 1997; 90 (1): 63–4.

38. Kuller JA, Katz , Mc oy M , ansen WF. Pregnancy complicated by Guillain Barré syndrome. South Med J. 199 ; 88(9): 987 9.

39. Mabie W . Peripheral neuropathies during pregnancy. lin bstet Gynecol. 200 ;48(1): 7 66.

40. Joint ask Force of the EF S and the P S. European Federation of eurological Societies Peripheral erve Society Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a oint task force of the European Federation of eurological Societies and the Peripheral erve Society First Revision. J Peripher erv Syst. 2010;1 (1):1 9.

41. Mc ombe PA, McManis PG, Frith JA, Pollard JD, Mc eod JG. hronic inflammatory demyelinating polyradiculoneuropathy associated with pregnancy. Ann Neurol. 1987;21(1):102 4.

42. Daroff RB, Fenichel GM, Jankovic J, Mazziotta J. Bradley’s neurology in clinical practice. 6th ed. Philadelphia: Saunders; 2012.

43. Niebyl JR. linical practice. ausea and vomiting in pregnancy. Engl J Med. 2010; 363(16):1 44 50.

44. Saperstein DS, Wolfe G , Gronseth GS, ations SP, erbelin , Bryan WW, et al. hallenges in the identification of cobalamin deficiency polyneuropathy. Arch eurol. 2003; 60(9):1296 301.

45. Awater , erres K, Rudnik Sch neborn S. Pregnancy course and outcome in women with hereditary neuromuscular disorders: comparison of obstetric risks in 178 patients. Eur J bstet Gynecol Reprod Biol. 2012;162(2):1 3 9.

46. Chaudhry , Escolar DM, ornblath DR. Worsening of multifocal motor neuropathy during pregnancy. eurology. 2002; 9(1):139 41.

47. Vine S, Shaffer M, Pauley G, Margolis EJ. A review of the relationship between pregnancy and porphyria and presentation of a case. Ann ntern Med. 19 7;47(4):834 40.