Spanaki Marianna V, Garcia Patricia, Schuger Claudio D, Smith Brien J
Neurology Department, Henry Ford Hospital, MI 48202-2689, USA.
Epileptic Disord. 2006 Sep;8(3):219-22.
Distinguishing epilepsy from syncope often can be challenging. We report a case of a 20-year-old patient with presumed refractory epilepsy since the age of 3 years. Although the clinical suspicion of syncope was raised at the age of 9 years, key historic features were not identified, cardiac work-up was not pursued and despite lack of electrographic evidence of epilepsy, he received anticonvulsant treatment. During his presurgical evaluation for "refractory epilepsy", one typical event was captured that was associated with asystole and normal electroencephalogram. The diagnosis of vasodepressor syncope was made and anticonvulsant medication was discontinued. With this case report, we would like to emphasize the importance of a meticulous history and the need to perform continuous video electroencephalographic with simultaneous electrocardiographic recordings in the evaluation of paroxysmal events with atypical presentation. [Published with video sequences].
区分癫痫和晕厥往往具有挑战性。我们报告一例20岁患者，自3岁起就被认为患有难治性癫痫。尽管在9岁时临床就对晕厥产生了怀疑，但未发现关键的病史特征，未进行心脏检查，并且尽管缺乏癫痫的脑电图证据，他仍接受了抗惊厥治疗。在他针对“难治性癫痫”进行术前评估期间，捕捉到一次典型事件，该事件与心搏停止及正常脑电图相关。最终诊断为血管减压性晕厥，并停用了抗惊厥药物。通过本病例报告，我们想强调详细病史的重要性，以及在评估表现不典型的阵发性事件时，进行连续视频脑电图同步心电图记录的必要性。[随视频序列发表]
