Neurogenic pulmonary oedema after epileptic seizure

A. M. Brambrink, I. Tzanova

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


The diagnosis “tonic clonic seizure” is frequently established by emergency physicians on scene. In patients with epilepsy mortality due to accidents, asphyxia, cardiac arrhythmias or postictal neurogenic pulmonary oedema (NPO) is twice as high as in the general population. We report a case of acute pulmonary oedema after a tonic clonic seizure. Following this event, the patient developed respiratory insufficiency and evidence of pulmonary oedema not associated with the classic aetiologies of congestive heart failure, aspiration or toxic exposure. The patient survived the incident after aggressive prehospital treatment, long-term intensive care and subsequent rehabilitation. A systematic case analysis and an introduction to the pathophysiology of NPO are presented. We recommend a positive approach to the management of NPO consisting primarily of interventions to stabilize vital functions, decrease intracranial pressure and normalize vegetative dysregulation. Emergency physicians need to consider the possibility of NPO in all cases of pulmonary oedema of unknown origin.

Original languageEnglish (US)
Pages (from-to)59-66
Number of pages8
JournalEuropean Journal of Emergency Medicine
Issue number1
StatePublished - 1998
Externally publishedYes


  • Epilepsy
  • Hydrostatic oedema
  • Increased intracranial pressure
  • Increased permeability oedema
  • Neurogenic pulmonary oedema
  • Systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Emergency Medicine


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