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Spontaneous bilateral chylothorax in a patient with epilepsy
Chloe Lawrence1, Callum Riley2, Shayan Lihony3
1ENT, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK cmlawrence0906@gmail.com.
BMJ Case Reports
|December 31, 2025
Summary
A woman developed bilateral chylothorax and respiratory failure after a seizure. This rare case suggests seizures may cause thoracic duct injury, leading to chylothorax, a condition typically linked to trauma or malignancy.
Area of Science:
- Medicine
- Pulmonology
- Critical Care
Background:
- Chylothorax, the accumulation of lymphatic fluid in the pleural space, is a rare condition.
- It is typically associated with malignancy, trauma, or infections.
- Atypical presentations and causes require further investigation.
Purpose of the Study:
- To report an unusual case of bilateral chylothorax.
- To explore a potential novel cause of thoracic duct injury.
- To highlight an atypical presentation of chylothorax.
Main Methods:
- Case report of a woman in her 30s.
- Clinical presentation, diagnostic workup, and treatment described.
- Literature review for similar cases and potential etiologies.
Main Results:
- Patient presented with cervical swelling, followed by bilateral pleural effusions and respiratory failure.
- Therapeutic thoracocentesis revealed chylous fluid.
- Respiratory failure resolved with treatment.
- No history of malignancy, infection, or trauma identified.
Conclusions:
- Bilateral chylothoraces can indicate multilevel thoracic duct injury.
- A significant epileptic seizure is hypothesized as a potential, previously unreported cause.
- This case broadens the understanding of chylothorax etiologies.
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