Post-ictal diffuse alveolar haemorrhage: clinical profile based on case reports

Diffuse alveolar haemorrhage (DAH) after a generalized tonic-clonic seizure is a rarely described illness likely involving physical disruption of alveolar-capillary interface similar to the mechanism of neurogenic pulmonary oedema. Based on our review of the English literature, only 11 cases have been reported to date. Recognition of this sparsely reported entity is important for optimal management, including avoidance of medications that have been implicated in causing DAH. Current experience with two additional patients with post-ictal DAH extends the reported experience to 13 and summarizes what is, to our knowledge, the entire experience of such patients reported in the English literature. This case report highlights the key aspects of clinical presentation, radiological and pathological findings, clinical course and management implications with the goal of enhancing awareness of this condition by respiratory clinicians.