Pulmonary embolism revealed by a seizure: a case report and literature review

Pulmonary embolism is a frequent disorder with a diagnostic approach based on probability estimation. Nevertheless, in some cases, prognosis may be impaired by delayed diagnosis resulting from atypical presenting manifestations. We report a 37-year-old woman, admitted for a seizure as the presenting...

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Bibliographic Details
Published in:La revue de medecine interne 2012-08, Vol.33 (8), p.457-460
Main Authors: Lam, M, Jammal, M, Tiev, K, Toledano, C, Fardet, L, Riviere, S, Josselin Mahr, L, Cabane, J, Kettaneh, A
Format: Article
Language:fre
Subjects:
Adult
Delayed Diagnosis
Diagnosis, Differential
Female
Humans
Pulmonary Embolism - complications
Pulmonary Embolism - diagnosis
Seizures - diagnosis
Seizures - etiology
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Summary:Pulmonary embolism is a frequent disorder with a diagnostic approach based on probability estimation. Nevertheless, in some cases, prognosis may be impaired by delayed diagnosis resulting from atypical presenting manifestations. We report a 37-year-old woman, admitted for a seizure as the presenting manifestation of pulmonary embolism, and review nine additional similar cases reported in the literature since 1945. Seizures were always generalized tonico-clonic in nature without a past medical history of epilepsy in any case. Tachycardia was noted in nine patients over ten. Prognosis was usually severe leading to death by cardiovascular deficiency in 70% of cases. These observations suggest a systematic suspicion of pulmonary embolism in the presence of generalized convulsion with persistent tachycardia after resolution of the episode and no past medical history of seizures. More research is necessary to assess the role of d-dimer testing in these situations.
ISSN:1768-3122
DOI:10.1016/j.revmed.2012.06.002