The usefulness of the head-up tilt test in patients with suspected epilepsy

Rangel, Inês; Freitas, João; Correia, Ana Sofia; Sousa, Ana; Lebreiro, Ana; Sousa, Carla; Maciel, Maria Júlia; Azevedo, Elsa

doi:10.1016/j.seizure.2014.02.004

Cited by 14 publications

(13 citation statements)

References 17 publications

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“…Four were population-based [9,10,24,32] studies recruiting patients from a base population of 75,200 [32], 15,000 [24], 200,000 [9] and 40,000 [10], respectively. Five studies (nine reports [21][22][23]27,[33][34][35][36][37]) recruited patients from head up tilt test (HUTT) or implantable electrocardiogram (ECG) recorder (ILR) centres. The remaining 17 studies recruited patients from epilepsy centres or tertiary hospitals.…”

Section: Patient Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Frequency of a false positive diagnosis of epilepsy: A systematic review of observational studies

Nguyen

Mohamed

et al. 2016

Seizure

105

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Section: Patient Characteristicsmentioning

confidence: 99%

“…The remaining 17 studies recruited patients from epilepsy centres or tertiary hospitals. One study [25] recruited patients with pseudo-refractory epilepsy, five studies (seven reports [34][35][36][38][39][40][41]) recruited patients with refractory epilepsy.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Frequency of a false positive diagnosis of epilepsy: A systematic review of observational studies

Nguyen

Mohamed

et al. 2016

Seizure

105

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“…More importantly, it is possible that VVS and epilepsy coexist. Recent study indicated that 21 percent of epilepsy patients demonstrated the positive head-up tilt table test 17. Thus, even patients compatible to the criteria of syncope used in this study, still have a possibility that their unconsciousness resulted from seizure.…”

Section: Discussionmentioning

confidence: 56%

Plasma Brain-Type Natriuretic Peptide Level Following Seizure and Syncope: Pilot Study

Park¹

2014

J Epilepsy Res

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Background and Purpose:To explore the clinical feasibility of plasma brain-type natriuretic peptide (proBNP) level to differentiate the two major causes of transient unconsciousness, seizure and vasovagal syncope (VVS) in adult patients.Methods:ProBNP levels were evaluated within 24 hours following attack in patients who had experienced a transient episode of unconsciousness. For confirmatory diagnosis, clinical history was reviewed thoroughly and several work-ups including electroencephalography and cerebral imaging and tilt-table test, were performed in cases of putative VVS, as a part of routine clinical approaches.Results:According to various relevant evaluations, 15 patients were diagnosed as seizure (age, 40.3±13.8 years) and 12 patients were VVS (age, 38.1±17.1 years). Plasma concentrations of pro-BNP were not different between two groups (p=0.714). Median level was 34.3 pg/mL (interquartile range: 12.9–91.1) in post-seizure group and 32.3 pg/mL (interquartile range 8.9–77.4) in post-VVS group. Additionally, it was not correlated with the sampling times within 24 hours after the episodes.Conclusions:The plasma level of pro-BNP has a limited clinical value in differentiating seizure and vasovagal syncope in adults. However, the more validated results with a large population should be sought in the future studies to confirm its value.

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“…Few studies addressed the overlap between syncope and epilepsy [ 1 , 17 , 18 ]. Although the selection of patients was very restrictive (2.2% of consecutive patients followed in the Epilepsy Centers) OESYS shows a very high occurrence of syncope, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…This could implicitly confirm the presence of epilepsy in this group, in some cases, coexisting with syncope. Rangel et al showed the coexistence of syncope and epilepsy only in 21% of the patients with refractory epilepsy [ 18 ]. As suggested before, the higher prevalence observed in our study may be due to a higher mean age with respect to those patients studied by Rangel et al [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Syncope and Epilepsy coexist in ‘possible’ and ‘drug-resistant’ epilepsy (Overlap between Epilepsy and Syncope Study - OESYS)

et al. 2017

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BackgroundDifferential diagnosis between syncope and epilepsy in patients with transient loss of consciousness of uncertain etiology is still unclear. Thus, the aim of the present work is to evaluate the prevalence of syncope in patients with “possible” or “drug-resistant” epilepsy.MethodsThe Overlap between Epilepsy and SYncope Study (OESYS) is a multicenter prospective observational study designed to estimate the prevalence of syncope in patients followed in Epilepsy Centers for “possible” or “drug-resistant” epilepsy and assessed according the European Society of Cardiology (ESC) guidelines of syncope diagnosis.ResultsOne hundred seven patients were evaluated; 63 (58.9%) had possible and 44 (41.1%) drug-resistant epilepsy. A final diagnosis of isolated syncope was in 45 patients (42.1%), all with possible epilepsy (45/63, 71.4%). Isolated epilepsy was found in 21 patients (19.6%) and it was more frequent in the drug-resistant than in the possible epilepsy group (34.1% vs. 9.5%, p = 0.002). More importantly, syncope and epilepsy coexisted in 37.4% of all patients but the coexistence was more frequent among patients with drug-resistant than possible epilepsy (65.9% vs. 17.5%, p < 0.001).ConclusionsIsolated syncope was diagnosed in ≈ 70% of patients with possible epilepsy. Syncope and epilepsy coexisted in ≈ 20% of patients with possible and in ≈ 60% of patients with drug-resistant epilepsy. These findings highlight the need of ESC guidelines of syncope approach in patients with possible and drug-resistant epilepsy.

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The usefulness of the head-up tilt test in patients with suspected epilepsy

Cited by 14 publications

References 17 publications

Frequency of a false positive diagnosis of epilepsy: A systematic review of observational studies

Frequency of a false positive diagnosis of epilepsy: A systematic review of observational studies

Plasma Brain-Type Natriuretic Peptide Level Following Seizure and Syncope: Pilot Study

Syncope and Epilepsy coexist in ‘possible’ and ‘drug-resistant’ epilepsy (Overlap between Epilepsy and Syncope Study - OESYS)

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