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Trauma and syncope-evidence for further sleep study? A case report
Erik Skobel1, Andreas Bell1, Dang Quan Nguyen1
1Erik Skobel, Clinic for Cardiac and Pulmonary Rehabilitation, "An der Rosenquelle", 52077 Aachen, Germany.
World Journal of Cardiology
|March 27, 2015
Summary
An 83-year-old male with traumatic brain injury experienced seizures and syncope. Obstructive sleep apnea was diagnosed, and pacemaker implantation resolved his seizures, suggesting a link between sleep apnea, arrhythmias, and trauma.
Area of Science:
- Neurology
- Cardiology
- Sleep Medicine
Background:
- Traumatic brain injury following syncope and seizures can have complex underlying causes.
- Investigating co-occurring conditions is crucial for comprehensive patient care.
Observation:
- An elderly male with a history of seizures, coronary artery disease, and paroxysmal atrial fibrillation (AF) presented with traumatic brain injury after syncope.
- Despite initial investigations, the cause of his seizures and syncope remained undetermined.
- During rehabilitation, the patient reported persistent seizures, excessive sleepiness, and snoring, prompting further investigation.
Findings:
- Sleep apnea diagnostics revealed severe obstructive sleep apnea (OSA) with an apnea-hypopnoea index of 35/h.
- Nocturnal monitoring identified paroxysmal atrial fibrillation (AF) with sudden tachycardia, and a 5-second sinus arrest (sick sinus syndrome) preceding seizures.
- Implantation of a DDD-pacemaker effectively eliminated seizure activity.
Implications:
- Screening for obstructive sleep apnea may uncover previously unidentified causes of syncope and associated trauma.
- The frequent co-occurrence of sleep apnea and cardiac arrhythmias suggests a potential etiological link, offering new therapeutic avenues.
- Managing sleep apnea could mitigate risks associated with syncope and prevent traumatic injuries.
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