AUTHOR=Leong Waiian , Zhang Yueqi , Huang Xinxiang , Luo Zhendong , Wang Yanli , Rainer Timothy Hudson , Wai Abraham K. C. , Huang Yi 

TITLE=Seizure as the clinical presentation of massive pulmonary embolism: Case report and literature review

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.980847

DOI=10.3389/fmed.2022.980847

ISSN=2296-858X

ABSTRACT=Massive pulmonary embolism (MPE) is a high-risk medical emergency. Seizures as the clinical presentation of MPE is extremely rare, and to our knowledge there have been no reports of successful percutaneous, catheter-based treatment of MPE presenting with new-onset seizures and cardiac arrest. We report a 64 year old woman who presented with an episode of seizure which lasted for 5 hours. The seizure occurred 4 times within 12 hours after arrival at hospital and at the end she sustained a cardiac arrest.  There was no past history of seizure or cardiopulmonary disease.  Bilateral MPE was detected by Computed Tomography Pulmonary Angiogram and she was treated successfully with percutaneous, catheter-directed anticoagulant therapy. Pulmonary embolism related seizures are more difficult to diagnose and have a higher mortality than seizures in general. MPE should be suspected in patients presenting with new-onset seizures and hemodynamic instability.