Tabuzo Mykha Marie B, Ty Maxine Lourraine T, Jamora Roland Dominic G
Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City and Global City, Philippines.
Heliyon. 2023 Jul 16;9(7):e18335. doi: 10.1016/j.heliyon.2023.e18335. eCollection 2023 Jul.
Stokes-Adams attacks presenting as convulsions may be difficult to distinguish from epilepsy. Stokes-Adams Syndrome is a transient abrupt collapse into unconsciousness due to a sudden but pronounced decrease in cardiac output caused by change in heart rate and rhythm, resulting in syncope.
We report a patient who presented with multiple convulsive episodes managed as epilepsy, until she was found to have paroxysmal total atrioventricular block. Previously, she had been treated with anti-seizure medications without relief. Ventricular standstill was seen on cardiac monitoring and the convulsive episodes were determined as Stokes-Adams attacks. She underwent percutaneous coronary intervention and has been free of convulsive episodes since.
Awareness of distinction between seizures/epilepsy and convulsive syncope is important and may be life-saving. A good clinical history as well as simple non-invasive tests such as electroencephalogram and electrocardiogram are important in establishing correct diagnosis.
表现为惊厥的斯托克斯－亚当斯发作可能难以与癫痫区分。斯托克斯－亚当斯综合征是由于心率和节律变化导致心输出量突然但显著下降，进而引起短暂性突然昏厥并陷入昏迷，导致晕厥。
我们报告一名患者，该患者出现多次惊厥发作，最初被当作癫痫治疗，直到发现她患有阵发性完全性房室传导阻滞。此前，她接受抗癫痫药物治疗但无缓解。心脏监测显示心室停搏，惊厥发作被确定为斯托克斯－亚当斯发作。她接受了经皮冠状动脉介入治疗，此后未再出现惊厥发作。
认识到癫痫发作与惊厥性晕厥之间的区别很重要，这可能会挽救生命。详细的临床病史以及脑电图和心电图等简单的非侵入性检查对于确立正确诊断很重要。
