Journal of Advanced Intensive and Critical Care Medicine

Abstract

Pulmonary thromboembolism (PTE) is a life-threatening condition that can present with a wide range of symptoms, including atypical neurological manifestations such as seizures. We present a case of a previously healthy young adult who was admitted with a first-onset generalized tonic-clonic seizure and was subsequently diagnosed with massive pulmonary embolism. Clinical workup revealed hypoxia, tachycardia, and inconclusive brain imaging. Elevated D-dimer prompted computed tomography pulmonary angiography, which revealed extensive bilateral pulmonary arterial embolisms. Treatment with low molecular weight heparin followed by direct oral anticoagulants resulted in significant improvement. Pulmonary embolism rarely presents as a new-onset seizure without cardiopulmonary symptoms, complicating the diagnosis. This case underscores the importance of early suspicion, comprehensive imaging, and multidisciplinary management in patients with atypical seizure presentations accompanied by unexplained hypoxia or tachycardia, as timely intervention can reduce morbidity and mortality.