A 50-year-old white man presented to the emergency department with right-sided focal seizures with secondary generalization. The first episode was 3 h prior to hospital admission; his daughter, who called an ambulance, witnessed the second episode. The patient worked as an engineer and denied any history of smoking or alcohol abuse. His medical history was unremarkable, with specifically no known convulsive or respiratory disorders. He was not taking any medications. He had no previous surgical history other than an uneventful root canal procedure 4 weeks prior. He was known to have clubbing, and abnormal chest radiograph findings since childhood, which had never been investigated. On further questioning, he reported recurrent spontaneous epistaxis and a long history of shortness of breath and chest pain with exertion, although he remained active.