[Severe pulmonary embolism revealed by status epilepticus].
BACKGROUND
High-risk pulmonary embolism (PE) is associated with high mortality rate (>50%). In some cases, diagnosis of PE remains a challenge with atypical presentations like in this case report with a PE revealed by status epilepticus.


METHODS
We report the case of a 40-year-old man without prior disease, hospitalized in ICU for status epilepticus. All paraclinical examinations at admission did not show any significant abnormalities (laboratory tests, cardiologic and neurological investigations). On day 1, he presented a sudden circulatory collapse and echocardiography showed right intra-auricular thrombus. He was treated by thrombolysis and arteriovenous extracorporeal membrane oxygenation. After stabilization, computed tomography showed severe bilateral PE. He developed multi-organ failure and died 4days after admission.


CONCLUSIONS
Pulmonary embolism revealed by status epilepticus has rarely been reported and is associated with poor prognosis. Physicians should be aware and think of the possibility of PE in patients with status epilepticus without any history or risk factors of seizure and normal neurological investigations.
Réanimation polyvalente, CHU Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France. Electronic address: nicolas.allou@hotmail.fr.
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Allou
Pneumologie, CHU Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France. Electronic address: nathalie.coolen@chu-reunion.fr.
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Coolen-Allou
Réanimation polyvalente, CHU Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France. Electronic address: benjamin.delmas@chu-reunion.fr.
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Delmas
Réanimation polyvalente, CHU Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France. Electronic address: charlotte.cordier@chu-reunion.fr.
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Cordier
Réanimation polyvalente, CHU Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France. Electronic address: allyn.jer@gmail.com.
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Allyn
D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D012720:Severity of Illness Index; D013226:Status Epilepticus / Q000150:complications / Q000175:diagnosis*
Embolie pulmonaire; Pulmonary embolism; Seizure; Status epilepticus; Thromboembolic; Thromboembolique; Épilepsie; État de mal épileptique