THE UTILITY OF ILR AT THE PATIENT WHO HAS A NON-CARDIAC SYNCOPE (EPILEPSY)
Authors: Deguchi Yoshiaki
The background: Implantable loop recorders (ILRs) are a very useful inspection at the patients with syncope who is caused by unknown origin.
However, it is possible to do only the confirmation of the arrhythmia because it isn’t possible to do the measurement of the blood pressure, at the time,
Therefore, The non-cardiac syncope which included neurogenic epilepsy cannot be examined.
In the patients had implanted ILRs, It reports on 2 case that it was possible for which to evaluate the diagnosis and medication of the non-cardiac syncope (epilepsy).
The patient is a 73-year-old male and 12-year-old female with syncope.
Arrhythmia without the syncope was examined by the both patients in Holter. So it has implanted ILRs. Electroencephalography (EEG) was not seen abnormal findings.
After implanted, when the syncope has occurred, it was not found the abnormal rhythm, but the mixing of an electromyogram was seen.
From this thing It judged that the syncope of which the epilepsy resembles and it depends. So it began anti-epilepsy drug. After that, the syncope was not seen.
There is no abnormal in the electroencephalography in this period
From this experience, we used for the anti-epilepsy drug in to the patients who didn’t have an abnormal rhythm in ILRs when the syncope has occurred.
After medication, we could have patients with no symptom.
The conclusion: To use anti-epilepsy drug for the diagnosis is sometimes useful when the syncope has occurred without abnormal records in ILRS.
By the patient who repeats syncope after the ILR implanted, to use anti-epilepsy drug on a trial basis is a very useful thing for the diagnosis purpose. When the follow up, ILRS is very useful for the diagnosis of the non-cardiac syncope, too.