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KMID : 0311120100510010077
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Yonsei Medical Journal
2010 Volume.51 No. 1 p.77 ~ p.81
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Seizure-Like Activities during Head-Up Tilt Test-Induced Syncope
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Song Pil-Sang
Park Jung-Wae
On Young-Keun
Huh June
Kim Jun-Soo
Yim Hye-Ran
Kim Jun-Hyung
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Abstract
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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.
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KEYWORD
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Neurally mediated reflex syncope, seizure-like activities, head-up tilt test
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