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Paroxysmal Ventricular Standstill: A Rare Cardiac Manifestation of Syncope.
Am J Case Rep
June 2020
Emergency Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
BACKGROUND Transient abrupt loss of consciousness due to sudden but pronounced decrease in cardiac output caused by a change in heart rate and rhythm is termed Stokes-Adams disease. Causes of Stokes-Adams syndrome are 1) transition from normal rhythm to high grade block, 2) slowing of idioventricular rhythm in the course of complete heart block, and 3) abnormal ventricular rhythm such as ventricular tachycardia and ventricular fibrillation. Paroxysmal ventricular standstill is one of the rarest causes of Stokes-Adams attack.
View Article and Find Full Text PDFConvulsive syncope: a condition to be differentiated from epilepsy.
Epileptic Disord
December 2009
Department of Neurology, Cerrahpasa Medical School, Institute of Cardiology, University of Istanbul, Turkey.
The clinical presentation of epilepsy and syncope can be confusingly similar. We present a patient with reflex syncopal episodes that mimic seizures using video-EEG recordings. During the episodes, head/eye deviations, automatisms and dystonic movements, suggesting an epileptic seizure, were observed.
View Article and Find Full Text PDFUnrecognized paroxysmal ventricular standstill masquerading as epilepsy: a Stokes-Adams attack.
Epileptic Disord
June 2007
Emergency Department, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Recognition of cardiac syncope masquerading as epilepsy may be difficult in the Emergency Department. We report a middle-aged man with recent onset convulsions who posed a diagnostic puzzle before it was found that he had paroxysmal ventricular standstill with complete atrioventricular block: he made a complete recovery after temporary pacemaker insertion. The main lessons from this case were (1) a convulsive seizure of only seconds duration and with an abrupt return of consciousness suggests syncope not epilepsy, (2) repeated, convulsive syncopes without provocation suggest cardiac syncope, (3) a 12-lead ECG should be recorded as soon as possible after such a series of episodes and should not be discontinued until an event is captured, and (4) Emergency Department clinicians should be familiar with any automatic gain on their ECG machine, lest fast, atrial activity be mistaken for narrow complex tachycardia.
View Article and Find Full Text PDFImages in cardiovascular medicine. "Stokes-adams epilepsy": sometimes we need the electroencephalogram.
Circulation
August 2005
Cardiology Service, Hospital do Meixoeiro, Vigo, Pontevedra, Spain.
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