[Recurrent postictal pulmonary edema--a case report].

A 32-year-old woman was examined in the Department of Internal Medicine at Saiseikai Fukuoka General Hospital after a grand mal seizure on December 29, 1985. She had a history of eclampsia 5 years before but had had no evidence of convulsive seizure. Chest examination revealed rales over the bilateral chest. The cardiac examination revealed no abnormalities. Laboratory data on admission included a total white blood cell count of 13000/mm3. The electrocardiogram also failed to reveal any abnormalities. Analysis of arterial blood with the patient breathing room air revealed a PaO2 of 51.2 mmHg, PaCO2 of 33.1 mmHg and a pH of 7.426. The chest film showed diffuse bilateral nodular-appearing alveolar infiltrate and a normal cardiac size. Cardiac function test using Swan-Ganz catheter was performed after 10 hours of onset. However, no abnormalities in pulmonary arterial pressure (PAP) and pulmonary capillary wedge pressure (PCWP) were noted. She was treated with Latamoxef and supplementally inspired oxygen. A repeat chest roentgenogram taken 7.5 hours after admission showed marked improvement. She was discharged without any residual symptoms and continued as an outpatient under the administration of sodium valproate. However, the drug was discontinued because of the presence of seizure was under suspicion. On August 24, 1986, she was readmitted for pulmonary edema after another grand mal seizure. The clinical course was uneventful and was almost the same as the previous episode. She was treated with oxygen only, via nasal catheter.(ABSTRACT TRUNCATED AT 250 WORDS)