EP182 Caffeine for the treatment of post-puncture headache can provoke a convulsive attack

<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant <h3>Background and Aims</h3> Along with the classic triad of preeclampsia (PE) - edema, proteinuria, hypertension, many clinicians have used hyperuricemia (HU) as indicator of PE. <h3>Methods</h3> We examined 33 patients with preeclampsia, from whom, in addition to the standard clinical and laboratory examination, venous blood was collected and cerebrospinal fluid was collected during spinal anesthesia. Their parameters were compared with those of 55 practically healthy pregnant women - without background pathology and/or pathology of pregnancy; laboratory parameters and neurological status of which were assessed quantitatively at least three times - upon admission, on the 3-4th and 7-10th days of treatment. In all patients, along with generally accepted clinical, instrumental and laboratory tests, spectrophotometric determination of the concentrations of adenine, guanine, hypoxanthine, xanthine, uric acid (UA), and malondialdehyde was carried out in samples of cerebrospinal fluid and venous blood. <h3>Results</h3> It has been established that there is a clinical and pathobiochemical relationship between HU and eclamptic convulsive seizures: ‘strong’ HU - above 420 μmol/l - is the most pronounced unfavorable metabolic marker, predictor and, possibly, a direct factor in the transformation of preeclampsia into convulsive eclampsia. High levels of oxypurines in the cerebrospinal fluid are also an unfavorable prognostic sign for patients with preeclampsia. <h3>Conclusions</h3> 1. ‘Strong’ hyperuricemia and critically elevated levels of other oxypurines in patients with preeclampsia both in the blood serum and in the cerebrospinal fluid - is a prognostically reliable predictor of the transformation of even mild preeclampsia into convulsive eclampsia. 2.Caffeine and other methylxanthines may be proconvulsants in women with preeclampsia.