[Postictal pulmonary oedema: a review of the literature]

Postictal neurogenic pulmonary oedema is an infrequent condition of varying severity, probably related to sudden unexpected death in epilepsy (SUDEP). It is more frequent in patients with generalised tonic-clonic seizures of long duration or with status epilepticus.

Based on a review of the literature, the aim is to describe the clinical characteristics, pathophysiology, radiological findings, treatment and prognosis of patients with postictal pulmonary oedema.

A search of the literature was performed in the PubMed, Embase, Cochrane Database of Systematic Reviews and BVS databases using a combination of free terms. The limits of the search applied were: papers published between 1 January 2000 and 26 April 2018, and papers for which the abstract was available. Altogether 23 papers were found, most of which were clinical cases, and used to extract the information needed to carry out the review.

In postictal pulmonary oedema, generalised tonic-clonic seizures are the most frequently reported type. The most common clinical manifestations were dyspnoea and tachycardia appearing within a few minutes after the seizure. Among the paraclinical findings the most frequent was leukocytosis. In general terms, a good prognosis was found in most cases, with improvement of the oedema within a period of between 12 and 96 hours. Only two of the 21 patients reported died. In addition, in a clinical pathology study in patients with SUDEP, pulmonary oedema appeared in most cases.