Can syncope cause convulsive seizures in adults?

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Purpose: Convulsive epileptic seizures triggered by transient cerebral hypoperfusion ‘reflex anoxic seizures’ are well-described in children but are not commonly recognized in adults. Methods: We report a case series of 12 adults who presented acutely after generalized tonic–clonic seizures with a clear syncopal phase before the convulsion. We describe the aetiology, semiology and natural history of these events. Results: Four patients (33.3%) had relevant risk factors for development of seizures/active epilepsy. Five patients (41.7%) had recurrent events prior to initial review by an epileptologist, but when anti-syncope measures were instituted there were no seizure recurrences over a median follow-up period of 34.5 (interquartile range 29.3–41.8) months. Conclusions: Syncope may be an under-recognized trigger for convulsive acute symptomatic seizures. Avoidance of syncope may be more effective than anti-seizure medications in preventing reflex anoxic seizures.

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Kelly, D. M., & Costello, D. J. (2017). Can syncope cause convulsive seizures in adults? Clinical Autonomic Research, 27(4), 283–287.

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