Pulmonary thromboembolism presenting as epileptiform generalized seizure.

A 69-year-old patient with a new-onset generalized epileptiform tonic-clonic seizure was successfully diagnosed with pulmonary thromboembolism in the prehospital setting even though the clinical picture suggested an unknown, primarily neurological, problem. Prehospital diagnostic procedures also included capnometry and D-dimer assay. The former showed lower than normal end-tidal carbon dioxide pressure values, and a value of the latter proved to be highly pathological. In the intensive care unit the diagnosis of massive pulmonary thromboembolism was confirmed.