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

• Tipo: Artigo em Revista Científica Internacional
• Data: 2014

Autores

Rangel, I (Autor) Outra; Freitas, J (Autor) Outra; Correia, AS (Autor) Outra; Sousa, A (Autor) Outra; Lebreiro, A (Autor) Outra; de Sousa, C (Autor) FMUP; Maciel MJ (Autor) FMUP; Elsa Azevedo (Autor) FMUP

Revista

Título: Seizure : the journal of the British Epilepsy Association

Vol. 23 Nº 5

Páginas: 367-370

ISSN: 1059-1311

Editora: Elsevier

Indexação

ISI Web of Knowledge - 11 Citações

Scopus - 12 Citações

Classificação Científica

FOS: Ciências médicas e da saúde

Outras Informações

ID Authenticus: P-009-H71

DOI: 10.1016/j.seizure.2014.02.004

Abstract (EN): Purpose: It is estimated that approximately 20-30% of patients diagnosed with epilepsy have been misdiagnosed, and neurocardiogenic syncope (NCS) might frequently be the real cause of transient loss of consciousness (TLOC) episodes. We assessed the role of the head-up tilt test (HUTT) in patients previously diagnosed with refractory epilepsy to evaluate the ability of this test to correctly diagnose patients with NCS. Method: We retrospectively analysed the clinical records of 107 consecutive patients with a previous diagnosis of refractory epilepsy that were taking antiepileptic drugs and who were referred for HUTT between January 2000 and December 2010. During the subsequent follow-up, we recorded the treatments performed and the recurrence of symptoms. Results: Complete follow-up data were available for 94 (88%) patients, and the mean follow-up period was 80 +/- 36 months. The HUTT was positive in 54% of patients. Thirty-one (33%) patients were misdiagnosed with epilepsy, and 20 (21%) patients had a dual diagnosis of NCS and epilepsy. The recurrence of TLOC was reported in 55% of the patients, but it was significantly lower in the misdiagnosed group (42% versus 64%; P = 0.039). Conclusion: NCS is an important cause of epilepsy misdiagnosis. The HUTT is often critical for making an accurate diagnosis and subsequently selecting the appropriate treatment for patients presenting with TLOC. The diagnostic overlap between epilepsy and NCS is not uncommon, suggesting that electroencephalographic monitoring during a HUTT may play an important role in diagnosing patients with recurrent, undiagnosed TLOC episodes.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 4