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. 2010 Jan;51(1):77-81.
doi: 10.3349/ymj.2010.51.1.77. Epub 2009 Dec 29.

Seizure-like activities during head-up tilt test-induced syncope

Pil Sang Song  1 , June Soo Kim, Jungwae Park, Hye Ran Yim, June Huh, Jun Hyung Kim, Young Keun On
Affiliations

Seizure-like activities during head-up tilt test-induced syncope

Pil Sang Song et al. Yonsei Med J. 2010 Jan.

Abstract

Purpose: Some patients with neurally mediated reflex syncope may be misdiagnosed as epilepsy because myoclonic jerky movements are observed during syncope. The seizure-like activities during the head-up tilt test (HUT) have been rarely reported. The purpose of this study was to assess the characteristics of these seizure-like activities and evaluate whether there are differences in the clinical characteristics and hemodynamic parameters of patients with neurally mediated reflex syncope with and without seizure-like activities during HUT-induced syncope.

Materials and methods: The medical records of 1,383 consecutive patients with a positive HUT were retrospectively reviewed, and 226 patients were included in this study.

Results: Of 226 patients, 13 (5.75%) showed seizure-like activities, with 5 of these (2.21%) having multifocal myoclonic jerky movements, 5 (2.21%) having focal seizure-like activity involving one extremity, and 3 (1.33%) having upward deviation of eye ball. Comparison of patients with and without seizure-like activities revealed no significant differences in terms of clinical variables and hemodynamic parameters during HUT.

Conclusion: Seizure-like activities occurred occasionally during HUT-induced syncope in patients with neurally mediated reflex syncope. The seizure-like activities during HUT might not be related to the severity of the syncopal episodes or hemodynamic changes during HUT.

Keywords: Neurally mediated reflex syncope; head-up tilt test; seizure-like activities.

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Conflict of interest statement

The authors have no financial conflicts of interest.

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