title: Seizure-like activities during head-up tilt test-induced syncope.
abstract: OBJECTIVE
  Some patients with neurally mediated reflex syncope may be misdiagnosed as epilepsy because myoclonic jerky movements are observed during syncope. The seizure-like activities during the head-up tilt test (HUT) have been rarely reported. The purpose of this study was to assess the characteristics of these seizure-like activities and evaluate whether there are differences in the clinical characteristics and hemodynamic parameters of patients with neurally mediated reflex syncope with and without seizure-like activities during HUT-induced syncope.
  
  
  METHODS
  The medical records of 1,383 consecutive patients with a positive HUT were retrospectively reviewed, and 226 patients were included in this study.
  
  
  RESULTS
  Of 226 patients, 13 (5.75%) showed seizure-like activities, with 5 of these (2.21%) having multifocal myoclonic jerky movements, 5 (2.21%) having focal seizure-like activity involving one extremity, and 3 (1.33%) having upward deviation of eye ball. Comparison of patients with and without seizure-like activities revealed no significant differences in terms of clinical variables and hemodynamic parameters during HUT.
  
  
  CONCLUSIONS
  Seizure-like activities occurred occasionally during HUT-induced syncope in patients with neurally mediated reflex syncope. The seizure-like activities during HUT might not be related to the severity of the syncopal episodes or hemodynamic changes during HUT.
authors.affiliation: Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Pil Sang
authors.initials: PS
authors.lastname: Song
authors.forename: June Soo
authors.initials: JS
authors.lastname: Kim
authors.forename: Jungwae
authors.initials: J
authors.lastname: Park
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Yim
authors.forename: June
authors.initials: J
authors.lastname: Huh
authors.forename: Jun Hyung
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Keun
authors.initials: YK
authors.lastname: On
mesh_terms: D000328:Adult; D004827:Epilepsy / Q000473:pathology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D018667:Tilt-Table Test / Q000009:adverse effects*; D055815:Young Adult