Accurate diagnosis of convulsive syncope: role of an implantable subcutaneous ECG monitor.
Convulsive syncope due to transient bradycardia is recognized as a cause of treatment-resistant seizures. However, the diagnosis may be difficult to make with conventional electrocardiographic devices if attacks are infrequent. We present a case of apparent epilepsy in which a new implantable electrocardiographic event recorder (the 'Reveal' insertable loop recorder) was used to show that attacks were caused by prolonged asystole of up to 36 s in duration. The insertable loop recorder may have an important role in the investigation of patients with treatment-resistant seizures, particularly where there is a strong suspicion of an underlying cardiac arrhythmia.
Zaidi
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A
The Royal Infirmary, Manchester Heart Centre, Oxford Road, Manchester, M13 9WL, UK. ami@mhc.cmht.nwest.nhs.uk
Clough
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P
Mawer
G
G
Fitzpatrick
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A
D000328:Adult; D001919:Bradycardia / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D004827:Epilepsy / Q000150:complications*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D010138:Pacemaker, Artificial; D019736:Prostheses and Implants; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome