Seizure-Like Activities during Head-Up Tilt Test-Induced Syncope |
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Authors: | Pil Sang Song June Soo Kim Jungwae Park Hye Ran Yim June Huh Jun Hyung Kim and Young Keun On |
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Institution: | 1Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.;2Department of Pediatrics, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.;3Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. |
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Abstract: | PurposeSome 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 MethodsThe medical records of 1,383 consecutive patients with a positive HUT were retrospectively reviewed, and 226 patients were included in this study.ResultsOf 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.ConclusionSeizure-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. |
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Keywords: | Neurally mediated reflex syncope seizure-like activities head-up tilt test |
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