Background: The occurrence of postpartum fits is often diagnoses as eclampsia without complete investigations.The case for further evaluation is stronger when the seizures are eleven (11) days postpartum as eclampsia is uncommon at this stage.Case Report: We describe the occurrence of postpartum grand mal fits resulting from right cerebral veinthrombosis with haemorrhagic infarction into the parietal lobe, initially diagnosed as eclampsia. Further investigations revealed an inherited thrombophilic defect. The wide-ranging implications for the diagnosis are addressed.Conclusions: The evaluation of a woman with postpartum fits should include an assessment for hitherto unknown cerebral pathology. The clear association of pregnancy-related venous thromboembolic event and in particular, young patients at atypical sites make screening for inherited and acquired thrombophilic defects indispensable.

Keywords: postpartum, MTHFR deficiency, thromboembolic event, thrombophilic defects