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In total, and alternative diagnosis was found in 31 patients (41.9%), including 13 (36.1%) of 36 patients taking an anticonvulsant medication. Nineteen patients (25.7%) developed profound hypotension of bradycardia during the head-up tilt test, confirming the diagnosis of vasovagal syncope. Two patients developed psychogenic symptoms during the head-up tilt test. Seven patients (9.5%) had significant ECG pauses during carotid sinus massage. In two patients, episodes of prolonged bradycardia correlated precisely with seizures according to the insertable ECG recorder. A simple, noninvasive cardiovascular evaluation may identify and alternative diagnosis in many patients with apparent epilepsy and should be considered early in the management of patients with convulsive blackouts. |
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arrhythmia,cardiac carotid sinus pressure convulsive syncope electrocardiogram,loop electroencephalogram electroencephalogram,abnormalities of intracardiac electrophysiologic testing misdiagnosis seizure seizure,diagnosis of seizure,differential diagnosis of syncope upright-tilt test
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