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Electroencephalographic findings during presyncope and syncope induced by tilt table testing

R S Sheldon1, M L Koshman, W F Murphy

  • 1Cardiovascular Research Group, Faculty of Medicine, University of Calgary, Alberta. bsheldon@cvr.ucalgary.ca

The Canadian Journal of Cardiology
|July 24, 1998
PubMed
Summary

Electroencephalogram (EEG) abnormalities occur during head-up tilt table testing-induced syncope. Abrupt EEG changes mark the transition from presyncope to syncope, indicating altered brain activity during these events.

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Area of Science:

  • Neuroscience
  • Cardiology
  • Clinical Neurophysiology

Background:

  • Syncope, a transient loss of consciousness, is often diagnosed using head-up tilt table testing.
  • Understanding the accompanying electroencephalogram (EEG) changes during syncope is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate electroencephalogram (EEG) alterations during syncope induced by head-up tilt table testing.
  • To characterize the EEG patterns associated with presyncope and syncope.

Main Methods:

  • A prospective observational study was conducted involving 18 patients with recurrent syncope.
  • Continuous EEG monitoring was performed during isoproterenol-induced head-up tilt table testing.
  • Hemodynamic parameters (blood pressure and heart rate) were recorded concurrently.

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Main Results:

  • EEG abnormalities were observed in 13/14 patients during presyncope and 18/18 patients during syncope.
  • Theta and delta wave slowing, along with background suppression, were common EEG findings.
  • Abrupt EEG rhythm changes occurred within 15 seconds of syncope onset in 14/18 patients.

Conclusions:

  • Head-up tilt table testing-induced presyncope and syncope are consistently associated with EEG abnormalities.
  • No single EEG pattern is uniquely diagnostic of presyncope or syncope.
  • The transition to syncope is characterized by rapid and significant changes in EEG patterns.