Tài liệu Báo cáo y học: "A case of mistaken identity: Asystole causing convulsions identified using implantab

A thirty four year old woman was referred to our syncope and autonomic disorder center for evaluation of recurrent unexplained periods of transient loss of consciousness (TLOC) associated with convulsive activity. The episodes would come on suddenly while sitting or standing with little or no prodrome. She would abruptly lose consciousness and fall to the floor. Bystanders reported her to be pale and ashen in color. Witnesses reported that during episodes she would display tonic-colonic like convulsive activity lasting from 1-5 minutes associated with urinary incontinence. The loss of consciousness could last for 30 to 45 minutes. Afterwards the patient was confused and fatigued for the remainder of the day. The patient had undergone multiple evaluations including, 12 lead electrocardiograms, echocardiography, stress testing, tilt table testing and prolonged holter and event monitoring, all of which were unremarkable. Repeated electroencephalograms (including a prolonged inpatient monitoring) were inconclusive and empiric therapy with multiple anti- seizure medications did not alter the frequency or severity of her TLOC.