Should I Perform an Electroencephalography in Patients with Syncope?/Senkoplu Hastalarda Elektroensefalografi Yapmali Miyim?

• Published in: Bagcilar Medical Bulletin Vol. 6; no. 1; p. 48
• Main Authors: Ates, Mehlika Panpalli, Can, Fatma Yilmaz
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.03.2021
• Subjects: Analysis; Care and treatment; Clinics; Comorbidity; Diagnosis; Electroencephalography; Epilepsy; Fainting
• ISSN: 2547-9431
• DOI: 10.4274/BMB.galenos.2020.09.065

Objective: Temporary loss of consciousness that occurs with temporary global cerebral hypoperfusion is defined as syncope. Infrequent changes can be seen in electroencephalography (EEG) during syncope. These EEG changes and findings are in the form of symmetric slowed-waves, spikes, or spike-wave complexes. In this study, the results and necessity of EEG in patients who applied to the neurology outpatient clinic with the complaint of syncope were evaluated. Method: In this study, the EEG results of 261 patients aged 17-86 years, who were evaluated in the general neurology outpatient clinic with the diagnosis of syncope between September 2018 and March 2019, were retrospectively analyzed. Patients with epilepsy were excluded. Data were obtained considering the demographic characteristics of the patients, comorbidities, the absence of epilepsy diagnosis, and the drugs they used. Results: Of the 261 syncope patients, 77% (n=201) had normal EEG findings, while 16.5% (n=43) had symmetric slowed-waves and sharply-contoured waves, 1.5% (n=4) had sharp and sharply-contoured waves, 1.5% (n=4) had focal slowed-waves, and 3.4% (n=9) had spike, and spike-wave complexes. Conclusion: In the diagnosis of patients presenting with syncope, taking a detailed history and questioning the background, first cardiovascular examination are more instructive than EEG. EEG should be performed in patients who cannot be decided with their clinic. Despite this, if it is still not sure, the diagnosis of epilepsy should be postponed and patients should be called for frequent control. Keywords: Electroencephalography, epilepsy, seizure, syncope Amac: Gecici global serebral hipoperfuzyon ile ortaya cikan gecici bilinc kaybi senkop olarak tanimlanmaktadir. Senkop esnasinda elektroensefalografide (EEG) sik olmayan degisiklikler gorulebilir. Bu EEG degisiklikleri ve bulgulari simetrik yavaslama, diken ya da dikendalga kompleksleri seklindedir. Bu calismada, senkop sikayetiyle noroloji poliklinigine basvuran hastalarda yapilan EEG sonuclari ve gerekliligi degerlendirildi. Yontem: Bu calismada, Eylul 2018-Mart 2019 arasinda senkop tanisi ile genel noroloji polikliniginde degerlendirilen 17-86 yas araliginda 261 hastanin, EEG sonuclari retrospektif olarak incelendi. Hastalarin demografik ozellikleri, ek hastaliklari, epilepsi tanisinin olmamasi ve kullandiklari ilaclar dikkate alinarak veriler elde edildi. Bulgular: Hastalarin %77'sinin (n=201) EEG'si normaldi. Hastalarin %16,5'inde (n=43) simetrik yavaslama ve keskin karakterli dalgalar, %1,5'inde (n=4) keskin ve keskin karakterli dalgalar, %1,5'inde (4) fokal yavaslik ve %3,4'unde (9) diken, diken-dalga kompleksleri izlendi. Sonuc: Senkop ile basvuran hastalarda teshiste, ayrintili oyku alinmasi ve ozgecmis sorgulanmasi, oncelikle kardiyovaskuler inceleme yapilmasi, EEG'den daha yol gostericidir. Klinigi ile karar verilemeyen, arada kalinan hastalarda EEG yapilmalidir. Buna ragmen yine de emin olunmazsa epilepsi tanisi ertelenmeli, hastalar sik kontrole cagrilmalidir. Anahtar kelimeler: Elektroensefalografi, epilepsi, nobet, senkop