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Case report: Recurrent postictal pulmonary edema.

R B Archibald, J D Armstrong

    Postgraduate Medicine
    |January 1, 1978
    PubMed
    Summary
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    Recurrent pulmonary edema after seizures can occur, especially with missed anticonvulsant medication. This condition, postictal pulmonary edema, presents with specific respiratory and clinical signs, resolving within days.

    Area of Science:

    • Neurology
    • Pulmonology
    • Critical Care Medicine

    Background:

    • Epilepsy management often involves regular anticonvulsant medication.
    • Seizures can precipitate various acute medical complications.
    • Postictal pulmonary edema is a recognized but less common complication.

    Observation:

    • A case of recurrent postictal pulmonary edema in a patient with grand mal seizures is presented.
    • Symptoms included dyspnea, cough with mucoid or hemorrhagic fluid, and hypoxemia.
    • Physical examination revealed rales and rhonchi, with chest imaging showing bilateral infiltrates.

    Findings:

    • Patients often present with normal blood pressure but may have elevated temperature.
    • Electrocardiogram (ECG) can be normal or show various abnormalities.

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  • Leukocytosis and significant arterial hypoxemia are common findings.

    • Implications:

    • This case highlights the importance of medication adherence in epilepsy patients.
    • Understanding postictal pulmonary edema aids in timely diagnosis and management.
    • Prompt treatment leads to clinical improvement within 24 hours and resolution in 3-5 days.