Tilt table test in the differential diagnosis of refractory "epilepsy".

Epilepsy is one of the most frequent causes of neurological disorders in young adults. We report the case of a patient who lived with the diagnosis of refractory epilepsy for twelve years, when actually the cause of the symptoms could be found with the performance of a tilt table test. Cardiologists should be aware of the possible diagnosis of neurocardiogenic syncope in patients previously diagnosed with epilepsy, especially in those with difficult therapeutic control.

Elderly patients with unexplained syncope: what should be considered a positive tilt test response?

Introduction: Syncope is a common problem and can lead to serious consequences in the elderly. Tilt test is useful to investigate recurrent syncope, but few studies have investigated the hemodynamic responses of this population to tilt test.

Objective: To describe the tilt test responses of elderly patients with recurrent syncope of unknown origin and to determine the occurrence of altered cardiovascular autonomic function in a subset of those with the diagnosis of dysautonomic pattern to the tilt test.

Parasympathetic-mediated atrial fibrillation during tilt test associated with increased baroreflex sensitivity.

The autonomic mechanism that triggered atrial fibrillation in a patient during tilt test was investigated. Neurocardiogenic syncope is often characterized by diminished baroreflex sensitivity during the hypotension period. Increased barorereflex sensitivity preceding the onset of atrial fibrillation in tilt testing may indicate the involvement of a vagally mediated mechanism, as shown in the present case.