Massive hemoptysis after generalized tonic clonic seizure requiring mechanical ventilation.
ABSTRACT A 38-year-old woman presented with massive hemoptysis (>200 mL/ 24 hours) occurring abruptly after generalized tonic clonic seizure. She experienced similar episodes of hemoptysis on three later occasions. Although the coexistence of hemoptysis and seizure has been reported, albeit rarely, as a clinical manifestation of postictal neurogenic pulmonary edema, massive hemoptysis after seizure is an extremely rare event with no recurrent cases of such episodes having ever been reported. The coexistence of hemoptysis and seizure increases the difficulty in diagnosis for the clinician. We describe the differential diagnosis among the diseases capable of causing seizure and hemoptysis.
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ABSTRACT: In the paper by FE James, VS Johnson, ZM Lenard and CS Mansfield published in the New Zealand Veterinary Journal 56, 85-88, 2008, entitled, Severe haemoptysis associated with seizures in a dog, the authors reported a case of repeated haemoptysis and radiographically visible severe bilateral alveolar lung pattern in a 7-year-old German Shepherd dog suffering from generalised tonic-clonic seizures. On the basis of several other examination methods, they concluded that The cause of the haemoptysis could not be defined in this dog, but was considered likely to be due to either severe neurogenic pulmonary oedema or rupture of the pulmonary capillaries secondary to seizures. Further in the text they stated that Haemoptysis associated with severe neurogenic pulmonary oedema, rather than traumatic rupture of the pulmonary capillaries may have occurred in this dog. I agree with these statements. This case reported by James et al. (2008) is very interesting, because there are few reports in the scientific literature of pulmonary complications of epilepsy, even in animals. We have been examining the pathophysiology of neurogenic pulmonary oedema for several years, and the pulmonary clinical signs of the case described are almost identical to what we have repeatedly observed (edý et al. 2007ab). Thus, I believe the complication of epilepsy presented in the case reported by James et al. (2008) was the neurogenic pulmonary oedema. Moreover, their case is very similar to previously published case reports in humans (e.g. see Ryu et al. 2002)continued.New Zealand veterinary journal 11/2008; 56(5):252. · 1.06 Impact Factor
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ABSTRACT: A 7-year-old, sterilised male German Shepherd dog was presented with a history of three episodes of severe haemoptysis and associated dyspnoea within a 3-week period. A generalised tonic-clonic seizure was witnessed preceding the third episode. Thoracic radiographs revealed a severe bilateral alveolar lung pattern of the caudodorsal lung fields; extension into the left cranial lung lobe was present but pulmonary vessels were within normal size limits. Frank blood was the only abnormality present at bronchoscopy. A coagulation profile, parasitological screening, thoracic and brain computed tomography (CT), and cerebrospinal fluid (CSF) cytological analysis did not identify any abnormalities. Haemoptysis due to either severe neurogenic pulmonary oedema or rupture of the pulmonary capillaries secondary to seizures was considered a possible diagnosis. The primary generalised seizures were attributed to late-onset idiopathic epilepsy diagnosed by exclusion of other causes. This is the first known case report describing severe haemoptysis associated with seizures in a dog.New Zealand veterinary journal 05/2008; 56(2):85-8. · 1.06 Impact Factor