John Libbey Eurotext

Epileptic Disorders

The Educational Journal of the

Convulsive syncope: a condition to be differentiated from epilepsy Volume 11, issue 4, December 2009

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  • Convulsive syncope: a condition to be differentiated from epilepsy

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Authors
Department of Neurology, Cerrahpasa Medical School, Institute of Cardiology, University of Istanbul, Turkey
  • Key words: syncope, reflex seizure, cardiac arrhythmia, convulsive syncope
  • DOI : 10.1684/epd.2009.0281
  • Page(s) : 315-9
  • Published in: 2009

The clinical presentation of epilepsy and syncope can be confusingly similar. We present a patient with reflex syncopal episodes that mimic seizures using video-EEG recordings. During the episodes, head/eye deviations, automatisms and dystonic movements, suggesting an epileptic seizure, were observed. The EEG revealed diffuse slow waves when the patient lost consciousness and complete cessation of the cerebral activity occurred when the dystonic movements started. On ECG recordings, bradycardia, followed by complete asystolia lasting for 40 seconds, was observed. We conclude that the differential diagnosis of epilepsy and syncope can be quite misleading and clinical features may not always be reliable. In cases where diagnosis is uncertain, circulatory and cardiac causes should always be kept in mind and video-EEG with simultaneous cardiac recordings are mandatory for accuracy of diagnosis. [Published with video sequences]