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March 21, 2016: Convulsive syncope: Nonelectrographic seizure

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March 21, 2016

Convulsive syncope: Nonelectrographic seizure

Convulsive syncope is characterized by seizure-like activity due to a brief period of cortical hypoxia, usually secondary to cardiac arrhythmia and transient cerebral hypoperfusion. The typical movements range from a single muscle twitch or multifocal myoclonus to tonic muscle activity with sudden loss of consciousness. Automatisms and tonic-clonic movements are also reported. Clinical presentation can be markedly similar to epilepsy. EEG, tilt table testing and prolonged cardiac monitoring are helpful to differentiate such episodes from epileptic seizures. Characteristic EEG findings consist of generalized slowing evolving to complete cessation of cerebral electrical activity, correlating with EKG changes. This entity should be considered in the evaluation of recurrent syncope and drug resistant epilepsy in young patients.

  1. Ozkara C, Metin B, Kucukoglu S. Convulsive syncope: a condition to be differentiated from epilepsy. Epileptic Disorder 2009: 11; 315-319.
  2. Fernández Sanmartín M, Rodríguez Núñez A, Martinón-Torres F, et al. Convulsive syncope: characteristics and reproducibility using the tilt test. An Pediatr (Barc) 2003; 59: 441-417.

Submitted by Nidhiben Anadani, MBBS, Neurology Resident, Rutgers-NJMS, Newark, New Jersey.

Dr. Anadani reports no disclosures.

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