Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Nov;42(11):4727-4729.
doi: 10.1007/s10072-021-05410-z. Epub 2021 Jun 21.

Recurrent convulsive syncope misdiagnosed as seizures due to a diaphragmatic hernia

Roberto Acampora  1 , Gianpaolo Marte  2 , Rossana Scala  3 , Maria Lieto  3 , Pietro Maida  2 , Maria Pia Mazzaferro  3
Affiliations
Case Reports

Recurrent convulsive syncope misdiagnosed as seizures due to a diaphragmatic hernia

Roberto Acampora et al. Neurol Sci. 2021 Nov.

Abstract

Differential diagnosis of seizures and convulsive syncope may be challenging in clinical practice. Furthermore, a misleading diagnosis of epilepsy may be detrimental for the patient as it often implies an over-prescription and an over-use of antiepileptic drugs which can cause adverse reactions. Moreover, a wrong diagnosis also causes distress to the patient with the risk of performing plenty of investigations without any benefits on the symptoms. In this case, we present a 57-year-old patient suffering from recurrent convulsive syncope over the last 7 years for which he underwent several cardiological and neurological tests and took plenty of antiepileptic drugs without any benefits on his convulsive episodes with loss of consciousness. During hospitalization, a chest X-ray was performed revealing an unknown diaphragmatic hernia with eventration of the transverse colon in the right hemitorax and mild cardiac compression. The patient underwent laparotomic surgery and diaphragmatic reconstruction with complete recovery. After 6-month follow-up, the patient no longer had episodes of convulsive syncope.

Keywords: AED; Convulsive syncope; Morgagni-diaphragmatic hernia; Myoclonic jerks; Seizures.

PubMed Disclaimer

References

    1. Ozkara C, Metin B, Kucukoglu S (2009) Convulsive syncope: a condition to be differentiated from epilepsy. Epileptic Disord 11(4):315–319. https://doi.org/10.1684/epd.2009.0281 - DOI - PubMed
    1. Oishi Y, Ishimoto T, Nagase N et al (2004) Syncope upon swallowing caused by an esophageal hiatal hernia compressing the left atrium: a case report. Echocardiography 21:61–64 - DOI
    1. Demirkan B, Guray Y, Guray U et al (2009) An unusual presentation of diaphragmatic hernia. Echocardiography 26:1107–1108 - DOI
    1. Yildiz A, Tuncez A, Demirkan B et al (2013) An unusual cause of syncope: diaphragmatic hernia. Echocardiography 30:E136–E137 - DOI
    1. Pironi D, Palazzini G, Arcieri S, Candioli S, Manigrasso A, Panarese A, Filippini A (2008) Laparoscopic diagnosis and treatment of diaphragmatic Morgagni hernia. Case report and review of the literature. Ann Ital Chir 79(1):29–36 - PubMed

Publication types