Vasovagal syncope with seizure like activity

Specialties Emergency

Published

vasovagal syncope with seizure like activity: anyody seen it?

in other words, a typical vasovagal trigger, followed by fainting, and tonic movements.

this article claims an 8% incidence rate, and i am wondering if others have seen this. i haven't.

[color=#333333]http://heartdisease.about.com/cs/generallinks/a/syncopeseizure.htm

[color=#333333]in a 6-year study conducted by investigators at northwestern university, up to 8% of patients with vasovagal syncope displayed seizure-like activity when they lost consciousness during a tilt table study. these patients underwent extensive neurological evaluations including eeg (electroencephalogram - a study of the electrical signals produced by the brain), cat scans, and mri scans, and none proved to have evidence of a true seizure disorder. their seizure-like movements during syncope are apparently caused by temporary but extremely low blood pressure during the syncopal episode.

Up Vote Up Vote ×
Specializes in Government.

In my population (people desperate to get their driver's licenses back) it seems like EVERYONE has this! Seriously, I see this on medical reports every single day. I think the clinical picture is muddied by states like mine which will let you drive after a vasovagal event but not after a seizure. It skews what neurologists and treating MDs call the event.

I see a lot of neuros using this when a person has had an event but a negative EEG.

Up Vote Up Vote ×

Both my husband and my daughter have this reaction to shots and seeing their own blood drawn. Interesting to watch but no long-term effects noted in either.

Up Vote Up Vote ×
Specializes in cardiac, ortho, med surg, oncology.
In my population (people desperate to get their driver's licenses back) it seems like EVERYONE has this! Seriously, I see this on medical reports every single day. I think the clinical picture is muddied by states like mine which will let you drive after a vasovagal event but not after a seizure. It skews what neurologists and treating MDs call the event.

I see a lot of neuros using this when a person has had an event but a negative EEG.

Actually my son has neurocardiogenic syncope and it is a valid diagnosis. After his first event he had a negative EEG and cardiac work-up. A tilt table test verified neurocardiogenic syncope. His BP dropped from 118/70 to 60/46 on the tilt table within 7-8 minutes and his HR dropped to the 50's. Fastest tilt table faint seen at the level two trauma center he was tested at.

To answer the OP though, he has never manifested any seizure like activity with his syncope. His eyes roll back in his head and he goes down.

Up Vote Up Vote ×

At the blood donor center where I worked, some muscle twitching in the extremities wasn't uncommon in vasovagal syncope. They usually recovered as quickly as they started feeling bad.

Up Vote Up Vote ×
Specializes in Government.

Whoa! I never said it wasn't a valid diagnosis!!!! I just said it has become a slippery slope term which can be overused when the event has no known cause. Plus there is the weight of outcome consequences (e.g. commerical driver can continue to make 100K a year if it is a vasovagal event, minimum wage if it was a seizure.....)

Up Vote Up Vote ×
Specializes in School Nursing.

My husband has vasovagal syncope. I have only seen him have seizure-like activity once, during a blood draw. It was our premarital bloodwork-I think he was probably nervous to begin with!!

I think his brother has seizure symptoms, too.

Up Vote Up Vote ×
Specializes in cardiac, ortho, med surg, oncology.

Quickbeam what state are you in? When my son was diagnosed in WI the fainting alone was enough to suspend his driving privileges. Maybe that is why the diagnosis wasn't all that common there.

Up Vote Up Vote ×

I have a son who does this with blood draws, injections and just talking about IVs makes him nauseated... I wouldn't have believed it had I not witnessed it several times...

Up Vote Up Vote ×
Specializes in jack of all trades.

I have seen very similar in my dialysis patients but only a few times. These were pts with no hx of seizure disorder but would have seizure like activity when they became suddenly hypotensive during thier dialysis tx. I initially would suspect thier calcium levels may be the root but the only thing out of sort was the dialysis related hypotension.

Up Vote Up Vote ×
Specializes in ER.

I saw this all the time in OB.

Up Vote Up Vote ×
Specializes in med-surg, tele, psych, float,preop/pacu.

Have seen said symptoms stated in our preop area - usually after starting IVs on young male pts.

Up Vote Up Vote ×
+ Add a Comment