convulsive syncope

BACKGROUND: Transcranial magnetic stimulation (TMS) is an intervention for treatment-resistant depression (TRD) that modulates neural activity. Deep TMS (dTMS) can target not only cortical but also deeper limbic structures implicated in depression. Although TMS has demonstrated safety in adolescents, dTMS has yet to be applied to adolescent TRD. OBJECTIVE/HYPOTHESIS: This pilot study evaluated the safety, tolerability and clinical effects of dTMS in adolescents with TRD...

Differentiating between syncope and epileptic seizures can be challenging when a specific medical history is not available. We herein report a 70s man who exhibited recurrent, brief unresponsiveness while at rest on five occasions over a year. While there were no convulsions, the patient consistently reported urinary incontinence. These events were preceded by an epigastric rising sensation without chest symptoms, suggesting a possible diagnosis of temporal lobe epilepsy, and subsequent EEG revealed temporal semi-rhythmic delta activity...

Masquerading bundle branch block is an easily overlooked pattern on the ECG that indicates severe disease of the atrioventricular nodal conduction pathway. It is often caused by coronary artery disease, infiltrative diseases of the heart and idiopathic degeneration of the atrioventricular nodal conduction pathways. The diagnosis is easily missed as it needs a detailed interpretation of the ECG in addition to the clinical presentation of the patient. The presence of this specific bundle branch block pattern on the ECG indicates severe degeneration of the conduction system requiring intervention...

Repetitive transcranial magnetic stimulation (rTMS) is Food and Drug Administration cleared for clinical use in treatment-resistant depression and a growing list of other disorders. The clinical uptake of rTMS has been facilitated by its relatively benign adverse-effect profile compared with other treatment modalities. Seizure is a rare but serious adverse event that has been reported with rTMS, when dosage exceeds safety guidelines or in individuals at increased risk for seizure. Fortunately, most rTMS-induced seizures are typically transient, with no adverse sequelae, but they may lead to treatment discontinuation...

OBJECTIVE: To analyze the clinical and genetic characteristics of a patient with long QT syndrome type 14 (long QT syndrome-14, LQT14, OMIM # 616247) caused by a de novo CALM1 mutation. METHODS: The clinical data of the patient were collected, next-generation sequencing technology was used to determine the exome gene sequence of the patient, and the suspected pathogenic locus was verified by Sanger sequencing. RESULTS: A 5-year and 9-month-old girl was admitted to the hospital due to a syncopal episode...

We present a case involving an 87-year-old woman who had a hyperkalemic emergency. This condition was further complicated by complete heart block (CHB) and seizure-like activity. This case emphasizes the challenge of differentiating between seizures and convulsive syncope. Achieving an accurate diagnosis is essential for determining the appropriate medical treatment. This case report highlights the various symptoms and complications associated with hyperkalemia, emphasizing the importance of conducting a thorough examination to explore other potential causes...

BACKGROUND: Stokes-Adams attacks presenting as convulsions may be difficult to distinguish from epilepsy. Stokes-Adams Syndrome is a transient abrupt collapse into unconsciousness due to a sudden but pronounced decrease in cardiac output caused by change in heart rate and rhythm, resulting in syncope. CASE PRESENTATION: We report a patient who presented with multiple convulsive episodes managed as epilepsy, until she was found to have paroxysmal total atrioventricular block...

UNLABELLED: Mad honey contains grayanotoxin, which is commonly derived from the nectar of a few Rhododendron species. It is commonly used by natives of the Himalayas in the belief of its medicinal use. CASE PRESENTATION: The authors report a case of 62 years old male with mad honey poisoning who was presented to the emergency department with loss of consciousness and had bradycardia and hypotension on arrival. The patient received intravenous fluids, atropine, and vasopressor support and was closely monitored in the coronary care unit for 48 h...

Postural orthostatic tachycardia is a syndrome characterized by an elevated heart rate in response to standing. This syndrome typically presents in late adolescence and early adulthood, with a higher percentage occurring in females. This syndrome is often seen following a viral infection, pregnancy, surgery, or intense psychological stress. This condition presents a wide range of symptoms that vary depending on its unclear etiology. We present the case of a 21-year-old woman with convulsions associated with postural orthostatic tachycardia syndrome after being misdiagnosed with a psychiatric condition for many years...

OBJECTIVES: In October 2020 and March 2021, the Federal Drug Agency classified lamotrigine as class IB antiarrhythmic, announcing an increased risk of heart rhythm problems. We sought to investigate the nature of the arrhythmia signal with lamotrigine use compared to anticonvulsants with sodium and non-sodium blocking mechanisms. METHODS: This retrospective pharmacovigilance case-non-case study used disproportionality analysis to detect signals of adverse reaction of interest reported with lamotrigine to the FDA adverse event reporting system between 1998 and 2022...

INTRODUCTION AND OBJECTIVES: Cardioneuroablation (CNA), a technique based on radiofrequency ablation of cardiac vagal ganglia, was developed to treat recurrent vasovagal syncope (VVS) with a predominant cardioinhibitory component, as an alternative to pacemaker implantation. The aim of our study was to evaluate the safety and success rate of CNA guided by extracardiac vagal stimulation in patients with highly symptomatic cardioinhibitory VVS. METHODS: Prospective study of patients who underwent anatomically guided CNA at two cardiology centers...

Sports medicine providers often perform various outpatient procedures to manage musculoskeletal and neuropathic conditions. Vasovagal syncope is a rare but a possible complication. Convulsive syncope is one subtype that involves brief extensor stiffening and nonsustained myoclonus and can be easily mistaken for seizures. We present a case series of convulsive syncope as a complication of common sports medicine outpatient procedures. We aim to describe how to identify this condition, and offer risk stratification and management strategies to mitigate the risks of this complication...

For several years, the autonomic nervous system has played a central role in the pathophysiological mechanism of atrial fibrillation (AF), so much so that it has been considered one of the cornerstones of Coumel's triangle. The clinical and therapeutic management of AF secondary to sympatho-vagal imbalance represents one of the most important examples of how precision medicine should be applied. Increasing knowledge of this kind of arrhythmias has made it possible to select specific antiarrhythmic drugs and to diversify their use according to vagal or adrenergic AF forms...

The European Commission asked EFSA for a scientific opinion on the risks for human health of the presence of grayanotoxins (GTXs) in 'certain honey' from Ericaceae plants. The risk assessment included all structurally related grayananes occurring with GTXs in 'certain' honey. Oral exposure is associated with acute intoxication in humans. Acute symptoms affect the muscles, nervous and cardiovascular systems. These may lead to complete atrioventricular block, convulsions, mental confusion, agitation, syncope and respiratory depression...

Chronic neuropathic orofacial pain along with physical suffering can cause emotional, psychological and social difficulties, which significantly affects the quality of life of patients. Pain in the area of glossopharyngeal nerve innervation, especially chronic neuropathic, is relatively rare, but is significant because of the great suffering it causes to sufferers. It can be life threatening, due to the cardiac arrhythmia, syncope or convulsions it can cause. Drug treatment is often of limited effectiveness and can be fraught with side effects...

BACKGROUND: Four COVID-19 vaccines are approved for use in Australia: Pfizer-BioNTech BNT162b2 (Comirnaty), AstraZeneca ChAdOx1 (Vaxzevria), Moderna mRNA-1273 (Spikevax), and Novavax NVX-CoV2373 (Nuvaxovid). We sought to examine the type and management of immediate adverse events following immunisation (I-AEFI) after COVID-19 vaccination. METHODS: Retrospective review of I-AEFI recorded between July 2021 and June 2022 in 314 community pharmacies in Australia. RESULTS: I-AEFI were recorded in 0...

INTRODUCTION: Differentiating epileptic seizures from other causes of Transient Loss of Consciousness (TLOC) remains a challenge in the Emergency Department (ED), where it may lead to erroneous administration of anti-epileptic drugs. Although video electroencephalography (EEG) is the gold standard for diagnosing epileptic seizures, it is not widely available in ED settings. Therefore, simple and quick diagnostic techniques for patients with TLOC in ED are needed. We performed a meta-analysis to review relevant literature and determine the efficacy of serum lactate in differentiating epileptic seizures from other causes of TLOC in the ED setting...

Objectives: To analyze the risk factors associated with seizure-like activities during head up tilt test (HUTT)-induced syncope in children with vasovagal syncope (VVS) and assess the prognosis of these patients. Methods: This is a retrospective study. VVS children with or without seizure-like activities during HUTT-induced syncope were included in convulsive or non-convulsive group. The clinical characteristics, hemodynamic parameters during HUTT-induced syncope and follow-up data were reviewed from the HUTT case report form and analyzed...

Cardiac and neurological disorders are the main broad etiologies for loss of consciousness. Ictal bradycardia syndrome refers to epileptic discharges that profoundly disrupt normal cardiac rhythm, resulting in cardiogenic syncope during the ictal event. Convulsive syncope is a well-described phenomenon in both adults and children in which abrupt cerebral hypoperfusion leads to brief extensor stiffening and non-sustained myoclonus. Sick sinus syndrome or tachycardia bradycardia syndrome is a common cause of arrhythmias in the elderly secondary to sinus node dysfunction...

Electroconvulsive therapy (ECT) is a well-known, safe, and efficient treatment for a variety of psychiatric diseases. We present here an unusual case of a 34-year-old patient with major depression, who developed convulsive status epilepticus persistent for eight days in connection to her first ECT-a very uncommon but serious complication. The patient was, prior to ECT treatment, treated with lithium carbonate and clomipramine for her depression. Six years prior to the ECT, the patient had experienced a convulsive syncope resulting in traumatic subarachnoid haemorrhage...