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Can syncope cause convulsive seizures in adults?
Dearbhla M Kelly1, Daniel J Costello2
1Epilepsy Service, Department of Neurology, Cork University Hospital, Cork, Ireland.
Summary
Reflex anoxic seizures, triggered by transient cerebral hypoperfusion, are often overlooked in adults. Implementing anti-syncope measures effectively prevented seizure recurrences in a case series.
Area of Science:
- Neurology
- Epileptology
- Cardiology
Background:
- Reflex anoxic seizures (RAS) are typically recognized in children.
- Adult cases of RAS triggered by transient cerebral hypoperfusion are underdiagnosed.
Purpose of the Study:
- To describe the aetiology, semiology, and natural history of RAS in adults.
- To highlight syncope as an under-recognized trigger for convulsive seizures in adults.
Main Methods:
- Case series of 12 adult patients presenting with generalized tonic-clonic seizures preceded by syncope.
- Detailed description of the aetiology, semiology, and clinical course.
Main Results:
- 33.3% of patients had risk factors for epilepsy.
- 41.7% experienced recurrent events before specialist review.
- Anti-syncope measures led to no seizure recurrences during a median follow-up of 34.5 months.
Conclusions:
- Syncope is a potential under-recognized trigger for acute symptomatic seizures.
- Preventing syncope may be more effective than anti-seizure drugs for RAS.
- This suggests a shift in management focus from anti-epileptic drugs to syncope prevention.
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