Stephenson J, Breningstall G, Steer C, Kirkpatrick M,
Horrocks I, Nechay A,
Zuberi S. Anoxic-epileptic seizures: home video recordings
of epileptic seizures
induced by syncopes. Epileptic Disord. 2004 Mar;6(1):15-9.
Abstract
Occasionally, but more often than has been reported, true
epileptic seizures are triggered by non-epileptic syncopes. This combination of
syncope and epileptic seizure has been called an anoxic-epileptic seizure. A
few examples of such anoxic-epileptic seizures, including the induction of
status epilepticus, have been reported in books and medical journals, but no
video-recordings have been published. We show here home video recordings of the
first three known examples of the transition from the triggering syncope and
anoxic seizure, to the subsequent epileptic seizure. In the first two children,
a neurally-mediated syncope, probably mediated by prolonged expiratory apnoea
(so-called breath-holding spells), induces a long, clonic epileptic seizure
with some features of myoclonic absence. In the third example, a compulsive
Valsalva in an older autistic child provokes a vibratory tonic epileptic
seizure. In addition, we show two further video clips of the most usual type of
epileptic seizure induced by syncopes in very young children. In one, the video
recording begins after the end of the triggering syncope and shows a rhythmic
clonic seizure that includes repetitive vocalizations. The final recoding is of
a spontaneous epileptic seizure with features of myoclonic absence: this child
had both epilepsy and identical episodes induced by syncopes, that is, anoxic-
epileptic seizures. Not only paediatricians and paediatric neurologists, but
also adult neurologists and epileptologists in general, should be aware of the
important clinical scenario of true epileptic seizures induced by syncopes.
This phenomenon is not considered in any international classification.
(Published with videosequences)
(You need to be patient with the download on these videos. For a while it seems like nothing is happening)
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