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Anoxic-epileptic seizures: observational study of epileptic seizures induced by syncopes Horrocks IA; Nechay A; Stephenson JB; Zuberi SMArch Dis Child 2005[Dec]; 90 (12): 1283-7AIMS: To describe a large series of children with anoxic-epileptic seizures (AES)--that is, epileptic seizures induced by syncopes. METHODS: Retrospective case-note review in a tertiary paediatric neurology unit. For all 27 children seen with a definite diagnosis of AES between 1972 and 2002, a review of clinical histories, videotapes, and EEG/ECG studies was undertaken. Main outcome measures were: age of onset, frequency and type of syncopes; age of onset and frequency of AES; type and duration of induced epileptic seizures; effect of treatment of syncopal and epileptic components. RESULTS: Median age of onset of syncopes was 8 months (range 0.2-120), frequency 2 in total to 40/day, median total approximately 200. Syncopes were predominantly reflex asystolic (RAS), prolonged expiratory apnoea (cyanotic breath-holding spells), or of mixed or uncertain origin; there was one each of ear piercing and hair grooming vasovagal syncope and one of compulsive Valsalva. Median age of onset of AES was 17 months (range 7-120), frequency from total 1 to 3/day, median total 3. The epileptic component was almost always bilateral clonic; three had additional epilepsy, one each with complex partial seizures, myoclonic absences, and febrile seizures plus. Median duration of epileptic component was 5 minutes (range 0.5-40, mean 11). Cardiac pacing prevented RAS in two patients: most other anti-syncope therapies were ineffective. Diazepam terminated the epileptic component in 6/8. Valproate or carbamazepine abolished AES in 5/7 without influencing syncope frequency. CONCLUSIONS: Although uncommon compared with simple syncopes, syncope triggered epileptic seizures (AES) are an important treatable basis of status epilepticus.|Age of Onset[MESH]|Anticonvulsants/therapeutic use[MESH]|Apnea/complications[MESH]|Child[MESH]|Child, Preschool[MESH]|Electrocardiography[MESH]|Electroencephalography[MESH]|Epilepsy/*etiology/physiopathology/therapy[MESH]|Female[MESH]|Humans[MESH]|Hypoxia/*complications[MESH]|Infant[MESH]|Infant, Newborn[MESH]|Male[MESH]|Retrospective Studies[MESH]|Syncope, Vasovagal/complications[MESH]|Syncope/*complications/physiopathology/therapy[MESH]|Valsalva Maneuver[MESH] |
