EPILEPTIC SEIZURES AND HYDATID CYST RUPTURE

AKPINAR G¹, ALTINBILEK E¹, GÜNDÜZ H¹, ÖZTÜRK D¹, GULEN B², İPEKCI A³, KOYUNCU M⁴, İKIZCELI ݹ

¹Sisli Hamidiye Etfal Training and Research Hospital, Department of Emergency Medicine, Istanbul - ²Bezmialem Vakif University Medical Faculty, Department of Emergency Medicine, Istanbul - ³Cerrahpasa Medical Faculty, Department of Emergency Medicine, Istanbul - ⁴Karabük Medical Faculty, Department of Emergency Medicine, Karabük, Turkey

Introduction: Diagnosis and treatment of a hydatid cyst continues to be a problem in endemic areas, such as Turkey. Hydatid cyst rupture into the peritoneum can cause severe anaphylactic reactions. The most common cause of intraperitoneal hydatid cyst rupture is cyst rupture occurring after trauma.

Case presentation: A 25-year-old male patient was brought to the emergency department with a complaint of a generalized tonic-clonic seizure while he was in the bathroom. For 3 days he had been receiving treatment for an influenza infection. His vital signs were blood pressure 140/70 mmHg, pulse 90/min, temperature 37 ⁰C, O2 saturation 95%. The patient’s physical examination was normal, and his electrocardiogram showed a normal sinus rhythm. His cranial computed tomography was normal. His laboratory findings were normal except for hyponatremia, and fluid-electrolyte treatment was provided. During monitoring, he did not develop any acute problem, his hyponatremia resolved and he was discharged with suggestions. The patient was found dead in his bed 5 hours after discharge. The autopsy showed that his death occurred due to a hydatid cyst rupture in his liver.

Conclusion: We concluded that the rupture was caused by a minimal trauma occurring during possible tonic-clonic convulsions. This condition should always be considered in a differential diagnosis in Turkey, where hydatid cyst cases are common.