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  • Title: Ventricular standstill disguised as epilepsy: A case report on Stokes-Adams attacks.
    Author: Tabuzo MMB, Ty MLT, Jamora RDG.
    Journal: Heliyon; 2023 Jul; 9(7):e18335. PubMed ID: 37519698.
    Abstract:
    BACKGROUND: Stokes-Adams attacks presenting as convulsions may be difficult to distinguish from epilepsy. Stokes-Adams Syndrome is a transient abrupt collapse into unconsciousness due to a sudden but pronounced decrease in cardiac output caused by change in heart rate and rhythm, resulting in syncope. CASE PRESENTATION: We report a patient who presented with multiple convulsive episodes managed as epilepsy, until she was found to have paroxysmal total atrioventricular block. Previously, she had been treated with anti-seizure medications without relief. Ventricular standstill was seen on cardiac monitoring and the convulsive episodes were determined as Stokes-Adams attacks. She underwent percutaneous coronary intervention and has been free of convulsive episodes since. CONCLUSION: Awareness of distinction between seizures/epilepsy and convulsive syncope is important and may be life-saving. A good clinical history as well as simple non-invasive tests such as electroencephalogram and electrocardiogram are important in establishing correct diagnosis.
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