Clinical differential diagnosis between syncope and epilepsy

2015 Fiscal Year Final Research Report

• Project/Area Number: 25461081
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: University of Occupational and Environmental Health, Japan
• Principal Investigator: ABE Haruhiko 産業医科大学, 医学部, 教授 (70231967)
• Co-Investigator(Kenkyū-buntansha): 河野 律子 産業医科大学, 医学部, 講師 (20449945)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Keywords: 失神 / てんかん / 心電図 / 感別診断 / QT dispersion / J波 / 早期再分極

Outline of Final Research Achievements

Objectives: To determine the clinical differential diagnosis between cardiogenic syncope and epilepsy, electrocardiographic (ECG) findings and clinical findings were analyzed. Methods: Magnitude of QT dispersion, J-point elevation and ST segment morphology after ER was assessed in 320 patients (30 ± 13 years; 54% men) with intractable epilepsy, 100 syncope patients, and 150 age- and sex-matched controls. Results: The magnitude of QTc dispersion was greater in epilepsy patients). In addition, ER prevalence (>0.1 mV and >0.2 mV J-point elevation) was greater in inferior ECG leads in epilepsy patients. Finally, among epilepsy patients with ER who achieved remission with antiepileptic therapy, both magnitude of QTc dispersions and J-point elevations were reduced (p=0.01, p=0.02, respectively vs. pre-treatment). Conclusions: Presence of automatism, ECG findings are useful marker for the differential diagnosis between cardiogenic syncope and epilepsy.

Free Research Field

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