We report a case of a 78-year-old man who presented several episodes of transient loss of consciousness preceded by sensation of ascending heat from the feet, with increasing frequency and duration within a few weeks. One month later he was admitted because he started to fall during the episodes, which became daily. Brain MRI detected a gliotic right frontal area, and EEG showed slow activity in the same region. Carbamazepine was started without clinical response despite high plasmatic level. Video-EEG polygraphic monitoring was performed and the patient showed an episode of left hemifacial clonic jerks followed by loss of consciousness, starting 17 s after the beginning of asystole. Synus rhythm reappeared 32 s later and the patient regained consciousness in few seconds. A pacemaker was implanted and carbamazepine was withdrawn. No further episodes occurred.
Cardiac asystoles misdiagnosed as epileptic seizures / V. Chiesa, A. Vignoli, M.P. Canevini. - In: BMJ CASE REPORT. - ISSN 1757-790X. - 2015:(2015). [10.1136/bcr-2014-206969]
Cardiac asystoles misdiagnosed as epileptic seizures
V. ChiesaPrimo
;A. VignoliSecondo
;M.P. CaneviniUltimo
2015
Abstract
We report a case of a 78-year-old man who presented several episodes of transient loss of consciousness preceded by sensation of ascending heat from the feet, with increasing frequency and duration within a few weeks. One month later he was admitted because he started to fall during the episodes, which became daily. Brain MRI detected a gliotic right frontal area, and EEG showed slow activity in the same region. Carbamazepine was started without clinical response despite high plasmatic level. Video-EEG polygraphic monitoring was performed and the patient showed an episode of left hemifacial clonic jerks followed by loss of consciousness, starting 17 s after the beginning of asystole. Synus rhythm reappeared 32 s later and the patient regained consciousness in few seconds. A pacemaker was implanted and carbamazepine was withdrawn. No further episodes occurred.Pubblicazioni consigliate
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