• M Lam, M Jammal, K Tiev, C Toledano, L Fardet, S Riviere, L Josselin Mahr, J Cabane, and A Kettaneh.
• 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.
• Rev Med Interne. 2012 Aug 1;33(8):457-60.

IntroductionPulmonary 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.Case ReportWe 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.ConclusionThese 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.Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

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