Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences

Vasovagal Syncope Treated as Epilepsy for 16 Years

Document Type : Case Report(s)

Authors

Ali Akbar Asadi-Pooya 1
Alireza Nikseresht 2
Ehsan Yaghoubi 2

1 Department of Neurology, Medical school, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Neurology, Thomas Jefferson University, Philadelphia, USA

2 Department of Neurology, Medical school, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract
The differentiation of vasovagal syncope and epileptic seizure is sometimes problematic, since vasovagal syncope may mimic epileptic seizures in many ways. The present report describes a patient who had been diagnosed and treated as having epilepsy with medically-refractory sei-zures for 16 years. Often, unlike epileptic seizures, tonic-clonic convulsions and postictal confusion are uncommon features of vasovagal syncope, but these may occur. Our patient was subjected to subcutaneous injection of one ml normal saline, which caused asystole leading to hypoxia and consequently a typical tonic-clonic convulsion. This patient was proved to have vasovagal syncope. The findings in the present case suggest that the possibility of vasovagal syncope should always be taken into consideration when evaluating patients with medically-refractory or unusual pattern of seizures. In such a circumstance, simultaneous video-electroencephalogram/electocardiogram monitoring may help achieve the correct diagnosis.

Keywords

Epilepsy
syncope
EEG

  • Received 22 April 2014
  • Revised 24 August 2020
  • Accepted 24 December 2018

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