From the Research
Yes, epilepsy appears to increase the risk for pulmonary embolism (PE), with people with epilepsy having approximately a 1.5 to 3 times higher risk of developing PE compared to those without epilepsy. This increased risk may be attributed to several factors, including seizures causing prolonged immobility, especially during the postictal (post-seizure) period, which is a well-established risk factor for blood clot formation 1. Additionally, some antiepileptic medications may affect blood coagulation pathways, and certain seizure types, particularly generalized tonic-clonic seizures, may cause trauma or inflammation that could potentially trigger clotting cascades. Patients with epilepsy often have comorbidities that independently increase PE risk, such as stroke or cardiovascular disease, as seen in a study that found patients with epilepsy had higher numbers of comorbidities compared to those with migraine 1.
Key factors that contribute to the increased risk of PE in epilepsy patients include:
- Prolonged immobility during the postictal period
- Effects of antiepileptic medications on blood coagulation pathways
- Trauma or inflammation caused by certain seizure types
- Presence of comorbidities that increase PE risk
For epilepsy patients, especially those with additional risk factors like obesity, smoking, or hormonal contraceptive use, healthcare providers should maintain vigilance for symptoms of PE, including sudden shortness of breath, chest pain, or rapid heart rate, as early recognition and prompt medical attention are crucial if PE is suspected 2. A study found that seizures can be a presenting symptom of PE, and a high level of suspicion for the disease is necessary to make an accurate diagnosis 2.
It is essential to note that the risk of PE in epilepsy patients is comparable to published rates among people with cancer, highlighting the need for increased awareness and vigilance among healthcare providers 1. By prioritizing the detection and management of PE risk factors in epilepsy patients, healthcare providers can help reduce the morbidity and mortality associated with this condition.