Key result
Permanent pacemaker implantation resolves recurrent syncope misdiagnosed as epilepsy in sinus node disease.
Why the study?
Distinguishing cardiovascular syncope from epilepsy is challenging, especially in patients who do not respond to anticonvulsant therapy.
Case Report (n=1)
Requires cardiac evaluation before epilepsy diagnosis in recurrent syncope; leaves open optimal monitoring strategies for unexplained loss of consciousness.
It is recognised that physicians can face difficulty in identifying the aetiology of an episode of loss of consciousness. This lesson reports the case of a patient who was diagnosed with epilepsy in 2008 after presenting with ‘funny turns’ and had more than 100 further blackouts before a correct diagnosis of sinus node disease was made in 2010. Implantation of a permanent pacemaker has abolished these episodes and restored the patient9s quality of life. Diagnostic and management strategies are discussed for patients presenting with loss of consciousness. Physicians are reminded of the difficulty in distinguishing cardiovascular syncope from epilepsy in such patients and the broader principle of questioning a diagnosis in those who do not appear to respond to treatment.
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Shah et al. (2011) conducted a case report in Syncope / Sinus node disease (n=1). Permanent pacemaker implantation was evaluated on Abolishment of syncopal episodes. Implantation of a permanent pacemaker abolished syncope episodes in a patient with sinus node disease who had been misdiagnosed with epilepsy for two years.
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