Heart rhythm problems often misdiagnosed as epilepsy

22/02/2011

One in eight adult patients in the UK, previously thought to be suffering from epilepsy but in whom this diagnosis was in doubt, in fact had heart rhythm abnormalities commonly found in patients with syncope, results of the REVISE trial have shown.

Previous studies have shown that up to 25% of patients thought to be suffering from epilepsy do not actually have this condition, and that many patients are taking drugs for epilepsy which they do not need. In some patients syncope can mimic epilepsy – a temporary decrease in blood supply to the brain which occurs in syncope can result in irritation of brain cells causing abnormal movements, which to a lay person can look very similar to epilepsy, he said. In the general population, syncope is much more common than epilepsy, affecting 25% of the population at any given time, more so in the elderly.

The study included 40 patients who had experienced at least three blackouts or "transient loss of consciousness" in the previous year and on examination by a neurologist there was doubt about the diagnosis of epilepsy. They were given an implantable ECG in a low risk, 20 minute operation and followed for nine months.

Results of the ECG monitoring showed that five of the patients had an abnormality in their heart rhythm and four of these patients who underwent a pacemaker insertion were subsequently found to be free of their symptoms.

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