Neurogenic Pulmonary Edema: A Case Report

Stella Onyi¹, Chukwuemeka A. Umeh^2, and John Yasmer¹

¹Department of Radiology, Hemet Valley Medical Center, Hemet, California, USA

²Department of Internal Medicine, Hemet Valley Medical Center, Hemet, California, USA

Cite this paper

Stella Onyi, Chukwuemeka A. Umeh and John Yasmer. Neurogenic Pulmonary Edema: A Case Report. American Journal of Medical Case Reports. 2021; 9(1):53-56. doi: 10.12691/AJMCR-9-1-13

Abstract

Background: Neurogenic pulmonary edema (NPE) is a rare pulmonary edema that develops rapidly after an acute central nervous system injury. The mechanism by which neurological insult leads to pulmonary edema is not well understood. The clinical presentation of NPE varies widely and ranges from asymptomatic cases to fulminant cases. Clinical signs in pure NPE are usually those of acute pulmonary edema, without signs of left ventricular failure. Case Report: The author presents a case of NPE is a young female patient with a brief epileptic seizure in which NPE resolved within 48 hours. Patient had no respiratory symptoms but was initially placed on antibiotics because her chest x-ray showed bilateral lung patchy opacifications in a perihilar distribution suggestive of pulmonary edema and/or multifocal pneumonia. Antibiotics was discontinued when the pulmonary edema resolved. Conclusion: There is need for physicians to be aware of NPE to avoid unnecessary antibiotics in asymptomatic patients who present with bilateral pulmonary infiltrates following an epileptic seizure.

Keywords

Neurogenic pulmonary edema, epilepsy, seizure disorder, case report

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Davison DL, Terek M, Chawla LS. Neurogenic pulmonary edema. Crit Care. 2012;16(2):212. Published 2012 Dec 12.
[2]	Wemple M, Hallman M, Luks AM. Neurogenic pulmonary edema. Parsons PE, Finlay G, editors. UpToDate [Internet]. Waltham, MA: UpToDate Inc. Available from https://www.uptodate.com (Accessed on December 04, 2019.).
[3]	Simon RP: Neurogenic pulmonary edema. Neurol Clin 1993, 11: 309-323.
[4]	Wayne SL, O'Donovan CA, McCall WV, Link K: Postictal neurogenic pulmonary edema: experience from an ECT model. Convuls Ther 1997, 13: 181-184.
[5]	Colice GL. Neurogenic pulmonary edema. Clinics in chest medicine. 1985 Sep; 6(3): 473-89.
[6]	Baumann A, Audibert G, McDonnell J, Mertes PM. Neurogenic pulmonary edema. Acta Anaesthesiologica Scandinavica. 2007 Apr; 51(4): 447-55.
[7]	Knudsen F, Jensen HP, Petersen PL. Neurogenic pulmonary edema: treatment with dobutamine. Neurosurgery 1991; 29:269.
[8]	Deehan SC, Grant IS. Haemodynamic changes in neurogenic pulmonary oedema: effect of dobutamine. Intensive Care Med 1996; 22: 672.
[9]	Chi CY, Khanh TH, Thoa le PK, et al. Milrinone therapy for enterovirus 71-induced pulmonary edema and/or neurogenic shock in children: a randomized controlled trial. Crit Care Med 2013; 41: 1754.
[10]	Wohns RN, Tamas L, Pierce KR, Howe JF. Chlorpromazine treatment for neurogenic pulmonary edema. Crit Care Med 1985; 13:210.