Yonsei Med J.  2010 Jan;51(1):77-81. 10.3349/ymj.2010.51.1.77.

Seizure-Like Activities during Head-Up Tilt Test-Induced Syncope

• Song PS
• Kim JS
• Park J
• Yim HR
• Huh J
• Kim JH
• On YK

• KMID: 1779609
• DOI: http://doi.org/10.3349/ymj.2010.51.1.77

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.

Keyword

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

MeSH Terms

Adult
Epilepsy/*pathology
Female
Hemodynamics
Humans
Male
Middle Aged
Retrospective Studies
Syncope/*diagnosis/*etiology/pathology
Tilt-Table Test/*adverse effects
Young Adult

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