Letter to the Editor
Isolated sixth nerve palsy: an unusual manifestation of preeclampsia
Neuropatía aislada del sexto nervio craneal. Una manifestación inusual de preeclampsia
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Representative transaxial tomographic slices are shown. Irregular cortical function is observed in both hemispheres, with defects of higher intensity in the orbitofrontal and temporal regions and small, diffusely distributed irregularities in the remaining areas of both hemispheres; no alterations are observed in the basal nuclei or cerebellum. Compared with the previous studies, an improvement is observed in the defects in the orbitofrontal and temporal regions, with normal uptake in the anterior frontal region.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Ramírez Ocaña, E. Espinosa Muñoz, C. Puentes Zarzuela" "autores" => array:3 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Ramírez Ocaña" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Espinosa Muñoz" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Puentes Zarzuela" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0213485317302463" "doi" => "10.1016/j.nrl.2017.07.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485317302463?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580819300859?idApp=UINPBA00004N" "url" => "/21735808/0000003400000009/v1_201911060652/S2173580819300859/v1_201911060652/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173580818302025" "issn" => "21735808" "doi" => "10.1016/j.nrleng.2018.12.005" "estado" => "S300" "fechaPublicacion" => "2019-11-01" "aid" => "1027" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Neurologia. 2019;34:618-20" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 497 "formatos" => array:3 [ "EPUB" => 31 "HTML" => 277 "PDF" => 189 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Kearns-Sayre syndrome: Absence of clinical response to treatment with oral folinic acid" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "618" "paginaFinal" => "620" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Kearns-Sayre: ausencia de respuesta clínica al tratamiento con ácido folínico oral" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 651 "Ancho" => 1867 "Tamanyo" => 69615 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Diffusion-weighted sequence (DWI b: 200) showing diffusion restriction in the affected areas.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Pardo Ruiz, D. Maturana Martínez, M. Vázquez López, Y. Ruiz Martín" "autores" => array:4 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Pardo Ruiz" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Maturana Martínez" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Vázquez López" ] 3 => array:2 [ "nombre" => "Y." "apellidos" => "Ruiz Martín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0213485317300282" "doi" => "10.1016/j.nrl.2017.01.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485317300282?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580818302025?idApp=UINPBA00004N" "url" => "/21735808/0000003400000009/v1_201911060652/S2173580818302025/v1_201911060652/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Isolated sixth nerve palsy: an unusual manifestation of preeclampsia" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "620" "paginaFinal" => "621" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A.E. Baidez Guerrero, N. García Lax, R. Hernández Clares, J.J. Martín Fernández" "autores" => array:4 [ 0 => array:3 [ "nombre" => "A.E." "apellidos" => "Baidez Guerrero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "N." "apellidos" => "García Lax" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "R." "apellidos" => "Hernández Clares" "email" => array:1 [ 0 => "rociohernandezclares@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 3 => array:3 [ "nombre" => "J.J." "apellidos" => "Martín Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neurología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Sección de Neurología, Hospital Universitario Reina Sofía, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Consulta de Neurooftalmología, Servicio de Neurología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neuropatía aislada del sexto nervio craneal. Una manifestación inusual de preeclampsia" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Preeclampsia is a pregnancy complication of unknown aetiology with an estimated frequency of 2%–8%. It is characterised by hypertension after week 20 of gestation in women with previously normal blood pressure, together with proteinuria, or in the absence of proteinuria but with presence of thrombocytopaenia, kidney failure, altered liver function, pulmonary oedema, or neurological symptoms.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> The most frequent neurological symptoms include headache and visual alterations, with isolated oculomotor palsy being exceptional.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> We present the case of a primiparous woman (37 weeks pregnant) whose first neurological symptom of preeclampsia was sixth nerve palsy; we also assess the possible action mechanisms.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Our patient was a 31-year-old woman assessed in the emergency department due to progressive onset of binocular diplopia in the horizontal plane, with no headache, fever, or other focal neurological signs. The neuro-ophthalmological evaluation revealed 20/20 Snellen visual acuity in both eyes, and the eye fundus examination showed well-defined papillae and spontaneous venous pulsation; the confrontation visual field test yielded normal results; esotropia was observed in the primary gaze position with slightly impaired adduction of the left eye. No other neurological alterations were observed. The general examination detected no fever, blood pressure values of 150/90<span class="elsevierStyleHsp" style=""></span>mm Hg, and distal oedema in both lower limbs; a blood analysis revealed thrombocytopaenia with 100<span class="elsevierStyleHsp" style=""></span>000<span class="elsevierStyleHsp" style=""></span>platelets/μL, increased LDH levels (418<span class="elsevierStyleHsp" style=""></span>IU/L), and proteinuria (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). In view of these symptoms, and considering the diagnosis of preeclampsia and findings suggestive of isolated sixth nerve palsy, we requested an MRI study before labour was induced. The MRI study ruled out an underlying intracranial lesion, and labour was induced 24<span class="elsevierStyleHsp" style=""></span>hours after the patient's admission to hospital; a healthy baby was born with no complications. After delivery, the patient presented normal blood pressure values and diplopia progressively improved, fully resolving in 48<span class="elsevierStyleHsp" style=""></span>hours.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Isolated sixth nerve or abducens nerve palsy during pregnancy is exceptional, although isolated cases have been reported.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3–6</span></a> The action mechanism by which preeclampsia causes neuropathy remains unknown, although the absence of other findings and previous published data in the literature suggest that it may cause vasospasm of the vasa nervorum, causing transient ischaemia that would lead to nerve palsy.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> In our patient, who had no history suggesting an underlying systemic disease, presenting preeclampsia and no fever, intracranial hypertension, or underlying intracranial lesion on MR images, together with the complete resolution of symptoms postpartum, suggest preeclampsia-related sixth nerve palsy.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Baidez Guerrero AE, García Lax N, Hernández Clares R, Martín Fernández JJ. Neuropatía aislada del sexto nervio craneal. Una manifestación inusual de preeclampsia. Neurología. 2019;34:620–621.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">ESR: erythrocyte sedimentation rate; GOT: glutamic oxaloacetic transaminase; GPT: glutamate-pyruvate transaminase; MCV: mean corpuscular volume.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Peripheral blood \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biochemical study \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Urine analysis \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Haemoglobin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.6<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total protein \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lactate dehydrogenase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">418<span class="elsevierStyleHsp" style=""></span>IU/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Protein++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Haematocrit \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Albumin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.7<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GOT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>IU/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MCV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85.0<span class="elsevierStyleHsp" style=""></span>fL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urea \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GPT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13<span class="elsevierStyleHsp" style=""></span>IU/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Glucose \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Platelets \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">4</span>/μL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Creatinine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ESR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20<span class="elsevierStyleHsp" style=""></span>mm/h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Uric acid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.7<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Leukocytes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14<span class="elsevierStyleHsp" style=""></span>380/μL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alkaline phosphatase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">110<span class="elsevierStyleHsp" style=""></span>IU/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2159266.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Blood test at admission.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preeclampsia: an update" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Lambert" 1 => "J.F. Brichant" 2 => "G. Hartstein" 3 => "V. Bonhomme" 4 => "P.Y. Dewandre" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Anaesthesiol Belg" "fecha" => "2014" "volumen" => "65" "paginaInicial" => "137" "paginaFinal" => "149" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25622379" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abducens nerve palsy complicating pregnancy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Thamban" 1 => "V. Nama" 2 => "R. Sharma" 3 => "P.J. Kollipara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/01443610600986987" "Revista" => array:6 [ "tituloSerie" => "J Obstet Gynaecol" "fecha" => "2006" "volumen" => "26" "paginaInicial" => "811" "paginaFinal" => "812" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17130041" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sixth nerve palsy: an unusual manifestation of preeclampsia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Barry-Kinsella" 1 => "M. Milner" 2 => "N. McCarthy" 3 => "J. Walshe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Obstet Gynecol" "fecha" => "1994" "volumen" => "83" "paginaInicial" => "849" "paginaFinal" => "851" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8159373" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolated sixth cranial nerve palsy in preeclampsia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.J. Thurtell" 1 => "K.L. Sharp" 2 => "J.M. Spies" 3 => "G.M. Halmagyi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Neuro-Ophthalmol" "fecha" => "2006" "volumen" => "26" "paginaInicial" => "296" "paginaFinal" => "298" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abducens nerve palsy in preeclampsia after delivery: an unusual case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.M. Park" 1 => "S.Y. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1447-0756.2007.00563.x" "Revista" => array:6 [ "tituloSerie" => "J Obstet Gynaecol Res" "fecha" => "2007" "volumen" => "33" "paginaInicial" => "543" "paginaFinal" => "545" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17688626" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolated abducens nerve palsy in preeclampsia and hypertension in pregnancy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.J. Vallejo-Vaz" 1 => "P. Stiefel" 2 => "V. Alfaro" 3 => "M.L. Miranda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Hypertens Res" "fecha" => "2013" "volumen" => "36" "paginaInicial" => "834" "paginaFinal" => "835" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735808/0000003400000009/v1_201911060652/S2173580819300847/v1_201911060652/en/main.assets" "Apartado" => array:4 [ "identificador" => "9409" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735808/0000003400000009/v1_201911060652/S2173580819300847/v1_201911060652/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580819300847?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 12 | 1 | 13 |
| 2024 September | 33 | 10 | 43 |
| 2024 August | 44 | 1 | 45 |
| 2024 July | 54 | 6 | 60 |
| 2024 June | 45 | 3 | 48 |
| 2024 May | 35 | 7 | 42 |
| 2024 April | 39 | 1 | 40 |
| 2024 March | 35 | 2 | 37 |
| 2024 February | 46 | 5 | 51 |
| 2024 January | 75 | 6 | 81 |
| 2023 December | 66 | 11 | 77 |
| 2023 November | 63 | 13 | 76 |
| 2023 October | 82 | 5 | 87 |
| 2023 September | 59 | 3 | 62 |
| 2023 August | 56 | 10 | 66 |
| 2023 July | 56 | 9 | 65 |
| 2023 June | 50 | 2 | 52 |
| 2023 May | 102 | 5 | 107 |
| 2023 April | 80 | 2 | 82 |
| 2023 March | 59 | 3 | 62 |
| 2023 February | 54 | 1 | 55 |
| 2023 January | 42 | 4 | 46 |
| 2022 December | 33 | 9 | 42 |
| 2022 November | 33 | 8 | 41 |
| 2022 October | 36 | 13 | 49 |
| 2022 September | 36 | 5 | 41 |
| 2022 August | 57 | 13 | 70 |
| 2022 July | 29 | 8 | 37 |
| 2022 June | 23 | 7 | 30 |
| 2022 May | 23 | 12 | 35 |
| 2022 April | 42 | 10 | 52 |
| 2022 March | 35 | 5 | 40 |
| 2022 February | 73 | 7 | 80 |
| 2022 January | 101 | 6 | 107 |
| 2021 December | 69 | 11 | 80 |
| 2021 November | 67 | 10 | 77 |
| 2021 October | 94 | 9 | 103 |
| 2021 September | 66 | 12 | 78 |
| 2021 August | 93 | 4 | 97 |
| 2021 July | 45 | 15 | 60 |
| 2021 June | 24 | 6 | 30 |
| 2021 May | 38 | 7 | 45 |
| 2021 April | 163 | 26 | 189 |
| 2021 March | 54 | 13 | 67 |
| 2021 February | 40 | 4 | 44 |
| 2021 January | 35 | 17 | 52 |
| 2020 December | 37 | 9 | 46 |
| 2020 November | 33 | 6 | 39 |
| 2020 October | 32 | 10 | 42 |
| 2020 September | 31 | 11 | 42 |
| 2020 August | 33 | 11 | 44 |
| 2020 July | 29 | 5 | 34 |
| 2020 June | 26 | 14 | 40 |
| 2020 May | 24 | 8 | 32 |
| 2020 April | 26 | 9 | 35 |
| 2020 March | 29 | 19 | 48 |
| 2020 February | 28 | 9 | 37 |
| 2020 January | 23 | 4 | 27 |
| 2019 December | 31 | 14 | 45 |
| 2019 November | 12 | 8 | 20 |
| 2019 October | 3 | 1 | 4 |
| 2019 September | 1 | 2 | 3 |
| 2019 August | 0 | 1 | 1 |
| 2019 July | 3 | 5 | 8 |
| 2019 June | 4 | 10 | 14 |
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