title: [Pulmonary embolism revealed by a seizure: a case report and literature review].
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Service de médecine interne, université Pierre-et-Marie-Curie Paris, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 184 rue du Faubourg-Saint-Antoine, Paris, France.
authors: M
authors: M
authors: Lam
authors: M
authors: M
authors: Jammal
authors: K
authors: K
authors: Tiev
authors: C
authors: C
authors: Toledano
authors: L
authors: L
authors: Fardet
authors: S
authors: S
authors: Riviere
authors: L
authors: L
authors: Josselin Mahr
authors: J
authors: J
authors: Cabane
authors: A
authors: A
authors: Kettaneh
mesh_terms: D000328:Adult; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis*; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology