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Syncope in patients with drug-resistant epilepsy without apparent cardiovascular disease

Síncope em pacientes com epilepsia fármaco resistente sem doença cardiovascular aparente

Epilepsy and syncope are clinical conditions with high prevalence rates in the general population, and the differential diagnosis between them is difficult.

Objective

To assess the frequency of syncope in patients diagnosed with drug-resistant epilepsy (DRE) without appa­rent heart disease, to investigate the relationship between clinical and electroencephalographic (EEG) changes, and to verify the role of the inclination test (IT).

Method

An open, prospective study from 2004 to 2006, including 35 consecutive patients from the Epilepsy Program of Hospital Universitário Clementino Fraga Filho who were diagnosed with DRE without apparent heart disease.

Results

The frequency of syncope was 25.7% (n=9), with a significant prevalence in women. Vasovagal syncope (VVS) was the most frequent diagnosis.

Conclusion

We found a significant association between syncope and the presence of autonomic symptoms (p=0.005). The IT plays an important role in the differential diagnosis of patients with DRE presenting with autonomic symptoms, regardless of EEG results and brain magnetic resonance imaging (MRI) abnormalities.

drug-resistant epilepsy; epilepsy; inclination test; syncope; pseudoseizures


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