Seizures in Idiopathic Pulmonary Arterial Hypertension

Abstract

Pulmonary arterial hypertension (PAH) is a progressive pulmonary vasculopathy. A 29-year-old female patient presenting with dyspnea and syncope within 6 hours of onset was admitted to our hospital. The patient stated that she looked for a neurologist months ago because she experienced abrupt shaking limbs occurring during physical activity. She was diagnosed with focal seizure, and carbamazepine (CBZ) was started. On admission, she reported that the dyspnea had started in the last week and recurrent episodes of syncope in the last few hours. A right heart catheterization was diagnostic of PAH. She was started on spironolactone, furosemide, sildenafil, warfarin, and supplemental oxygen. On 10th admission day, the patient was seizure free and the dose of CBZ was tapered. In the follow-up, the patient remained seizure free. An investigation to search for a chronic lung disease or hypoxemia, systemic disorder, hematological disorder, and metabolic disorder was negative.

Keywords

seizure - syncope - pulmonary hypertension

• References

• 1 Humbert M, Sitbon O, Chaouat A. et al. Pulmonary arterial hypertension in France: results from a national registry. Am J Respir Crit Care Med 2006; 173 (09) 1023-1030
• 2 Barst RJ, Ertel SI, Beghetti M, Ivy DD. Pulmonary arterial hypertension: a comparison between children and adults. Eur Respir J 2011; 37 (03) 665-677
• 3 Izzo A, McSweeney J, Kulik T, Khatwa U, Kothare SV. “Nocturnal seizures” in idiopathic pulmonary arterial hypertension. J Clin Sleep Med 2013; 9 (10) 1091-1092
• 4 Reuber M, Chen M, Jamnadas-Khoda J. et al. Value of patient-reported symptoms in the diagnosis of transient loss of consciousness. Neurology 2016; 87 (06) 625-633
• 5 Henderson MC, Tierney LM, Smetana GW. The Patient History: Evidence-Based Approach. China: McGraw Hill Professional; 2012: 281-292
• 6 Battaglia A, Guerrini R, Gastaut H. Epileptic seizures induced by syncopal attacks. J Epilepsy 1989; 2 (03) 137-145
• 7 Runo JR, Loyd JE. Primary pulmonary hypertension. Lancet 2003; 361 9368 1533-1544
• 8 Gastaut H, Bostem F, Naquet R, Guardiola A. Hypoxic activation of the EEG by inhalation of nitrogen. I. First results obtained in generalized epilepsies. Revue Neurologique 1959; 100: 501-510