title: Syncope and Epilepsy coexist in 'possible' and 'drug-resistant' epilepsy (Overlap between Epilepsy and Syncope Study - OESYS).
abstract: BACKGROUND
  Differential diagnosis between syncope and epilepsy in patients with transient loss of consciousness of uncertain etiology is still unclear. Thus, the aim of the present work is to evaluate the prevalence of syncope in patients with "possible" or "drug-resistant" epilepsy.
  
  
  METHODS
  The Overlap between Epilepsy and SYncope Study (OESYS) is a multicenter prospective observational study designed to estimate the prevalence of syncope in patients followed in Epilepsy Centers for "possible" or "drug-resistant" epilepsy and assessed according the European Society of Cardiology (ESC) guidelines of syncope diagnosis.
  
  
  RESULTS
  One hundred seven patients were evaluated; 63 (58.9%) had possible and 44 (41.1%) drug-resistant epilepsy. A final diagnosis of isolated syncope was in 45 patients (42.1%), all with possible epilepsy (45/63, 71.4%). Isolated epilepsy was found in 21 patients (19.6%) and it was more frequent in the drug-resistant than in the possible epilepsy group (34.1% vs. 9.5%, p = 0.002). More importantly, syncope and epilepsy coexisted in 37.4% of all patients but the coexistence was more frequent among patients with drug-resistant than possible epilepsy (65.9% vs. 17.5%, p < 0.001).
  
  
  CONCLUSIONS
  Isolated syncope was diagnosed in ≈ 70% of patients with possible epilepsy. Syncope and epilepsy coexisted in ≈ 20% of patients with possible and in ≈ 60% of patients with drug-resistant epilepsy. These findings highlight the need of ESC guidelines of syncope approach in patients with possible and drug-resistant epilepsy.
authors.affiliation: Department of Clinical and Experimental Medicine, Syncope Unit, Geriatric Cardiology and Medicine, University of Florence, Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ungar
authors.affiliation: Department of Clinical and Experimental Medicine, Syncope Unit, Geriatric Cardiology and Medicine, University of Florence, Florence, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Ceccofiglio
authors.affiliation: Department of Neurological and Psychiatric Sciences, Epilepsy Center, University of Florence, Florence, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pescini
authors.affiliation: Geriatric and Gerontology Institute, University of Modena, Modena, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mussi
authors.affiliation: Geriatric Unit, Santa Chiara Hospital, Trento, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Tava
authors.affiliation: Department of Clinical and Experimental Medicine, Syncope Unit, Geriatric Cardiology and Medicine, University of Florence, Florence, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Rafanelli
authors.affiliation: Division of Geriatrics, Ospedale "S. Maria di Ca' Foncello", Treviso, Italy.
authors.forename: Assunta
authors.initials: A
authors.lastname: Langellotto
authors.affiliation: Department of Clinical and Experimental Medicine, Syncope Unit, Geriatric Cardiology and Medicine, University of Florence, Florence, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Marchionni
authors.affiliation: Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: J Gert
authors.initials: JG
authors.lastname: van Dijk
authors.affiliation: Istituti Clinici Scientifici Maugeri- Syncope unit - UOC Cure sub-acute, Milan, Italy.
authors.forename: Gianlugi
authors.initials: G
authors.lastname: Galizia
authors.affiliation: Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 80131, Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonaduce
authors.affiliation: Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 80131, Naples, Italy. p.abete@unina.it.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Abete
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult