Why the study?
Differentiating between syncope and epileptic seizures can be challenging when a specific medical history is not available.
Urinary incontinence without convulsions may indicate cardiogenic syncope, such as complete atrioventricular block, rather than an epileptic seizure, emphasizing the need for thorough cardiac evaluation.
Prompts cardiac evaluation in seizure-like episodes with incontinence; leaves open confirmation beyond this case report.
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. In contrast, the ECG revealed a left bundle branch block, while the initial Holter ECG showed no abnormalities. However, subsequent follow-up examinations revealed a complete atrioventricular block necessitating permanent pacemaker implantation. It is important to exercise caution in the interpretation of EEG findings. Moreover, instances of 'urinary incontinence without convulsion' may indicate non-epileptic events.
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Neshige et al. (2023) studied this question.
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