{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T02:03:35Z","timestamp":1762999415516},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"51","license":[{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n            <jats:title>Abstract<\/jats:title>\n            <jats:p>The purpose of this study was to assess the prevalence and the characteristics of seizure-like activities during head-up tilt test (HUT)-induced syncope, in patients with suspected vasovagal syncope (VVS). We also evaluated the differences in hemodynamic parameters between patients with and without seizure-like activities.<\/jats:p>\n            <jats:p>A total of 71 patients with suspected VVS, who showed syncope during HUT between October 2010 and May 2013, were analyzed. Electrocardiogram and hemodynamic parameters were continuously monitored during HUT. We also performed video recording of patients during HUT to identify eyeball deviation or seizure-like limb movements.<\/jats:p>\n            <jats:p>In all, 47 patients (66.2%) showed seizure-like activities at the time of syncope during HUT, 14 patients presented eyeball deviation, without abnormal limb movements, and 33 patients showed abnormal limb movements, such as myoclonic or tonic-clonic activities, as well as eyeball deviation. Upon comparison of the 2 groups with or without seizure-like activities, patients showing seizure-like activities presented a significantly lower heart rate at the time of syncope in HUT (38.51\u200a\u00b1\u200a16.81 vs 49.67\u200a\u00b1\u200a20.12, <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a.05). Also, upon comparison within patients showing seizure-like activities, the patients who showed abnormal limb movements with eyeball deviation demonstrated a significantly lower systolic blood pressure and cardiac output at the time of syncope (34.30\u200a\u00b1\u200a12.24 vs 49.00\u200a\u00b1\u200a14.14, <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a.05; 0.58\u200a\u00b1\u200a0.40 vs 1.32\u200a\u00b1\u200a0.97, <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a.05).<\/jats:p>\n            <jats:p>Seizure-like activities were observed in high percentage in about 66% of patients during HUT-induced syncope. The occurrence of seizure-like activities was associated with more severe transient hemodynamic changes, such as lower heart rate, systolic blood pressure, and cardiac output at the time of the HUT-induced syncope.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/md.0000000000013602","type":"journal-article","created":{"date-parts":[[2018,12,20]],"date-time":"2018-12-20T03:16:34Z","timestamp":1545275794000},"page":"e13602","source":"Crossref","is-referenced-by-count":14,"title":["Seizure-like activities in patients with head-up tilt test-induced syncope"],"prefix":"10.1097","volume":"97","author":[{"given":"Byung-Euk","family":"Joo","sequence":"first","affiliation":[{"name":"Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae Lim","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Ran","family":"Yim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Stroke Vascular Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jungwae","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Stroke Vascular Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae-Won","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"June Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Stroke Vascular Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230914","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/00005792-199005000-00004","article-title":"Evaluation and outcome of patients with syncope","volume":"69","author":"Kapoor","year":"1990","journal-title":"Medicine (Baltimore)"},{"key":"R2-20230914","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1001\/jama.1982.03320440035029","article-title":"Syncope of unknown origin. The need for a more cost-effective approach to its diagnosis evaluation","volume":"247","author":"Kapoor","year":"1982","journal-title":"JAMA"},{"key":"R3-20230914","doi-asserted-by":"crossref","first-page":"714","DOI":"10.7326\/0003-4819-133-9-200011070-00014","article-title":"Vasovagal syncope","volume":"133","author":"Fenton","year":"2000","journal-title":"Ann Intern Med"},{"key":"R4-20230914","doi-asserted-by":"crossref","first-page":"3Q","DOI":"10.1016\/S0002-9149(99)00691-8","article-title":"Pathophysiology and differential diagnosis of neurocardiogenic syncope","volume":"84","author":"Grubb","year":"1999","journal-title":"Am J Cardiol"},{"key":"R5-20230914","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1093\/eurheartj\/ehy037","article-title":"2018 ESC guidelines for the diagnosis and management of syncope","volume":"39","author":"Brignole","year":"2018","journal-title":"Eur Heart J"},{"key":"R6-20230914","doi-asserted-by":"crossref","first-page":"871","DOI":"10.7326\/0003-4819-115-11-871","article-title":"Differentiation of convulsive syncope and epilepsy with head-up tilt testing","volume":"115","author":"Grubb","year":"1991","journal-title":"Ann Intern Med"},{"key":"R7-20230914","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1002\/ana.410360217","article-title":"Syncope: a videometric analysis of 56 episodes of transient cerebral hypoxia","volume":"36","author":"Lempert","year":"1994","journal-title":"Ann Neurol"},{"key":"R8-20230914","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1056\/NEJM198902093200603","article-title":"Provocation of bradycardia and hypotension by isoproterenol and upright posture in patients with unexplained syncope","volume":"320","author":"Almquist","year":"1989","journal-title":"N Engl J Med"},{"key":"R9-20230914","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1001\/archinte.163.16.1945","article-title":"Clinical spectrum and prevalence of neurologic events provoked by tilt table testing","volume":"163","author":"Passman","year":"2003","journal-title":"Arch Intern Med"},{"key":"R10-20230914","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S0735-1097(00)00700-2","article-title":"Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause","volume":"36","author":"Zaidi","year":"2000","journal-title":"J Am Coll Cardiol"},{"key":"R11-20230914","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1016\/S0140-6736(86)91665-X","article-title":"Head-up tilt: a useful test for investigating unexplained syncope","volume":"1","author":"Kenny","year":"1986","journal-title":"Lancet"},{"key":"R12-20230914","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1016\/0002-8703(91)90282-M","article-title":"Carotid sinus massage, eyeball compression, and head-up tilt test in patients with syncope of uncertain origin and in healthy control subjects","volume":"122","author":"Brignole","year":"1991","journal-title":"Am Heart J"},{"key":"R13-20230914","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.1093\/eurheartj\/ehp298","article-title":"Guidelines for the diagnosis and management of syncope (version 2009)","volume":"30","year":"2009","journal-title":"Eur Heart J"},{"key":"R14-20230914","doi-asserted-by":"crossref","first-page":"841","DOI":"10.4070\/kcj.2000.30.7.841","article-title":"Head-up tilt test in subjects with no history of syncope or presyncope","volume":"30","author":"Jeong","year":"2000","journal-title":"Korean Circ J"},{"key":"R15-20230914","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1097\/01.hjh.0000125439.28861.ed","article-title":"Time-domain cross-correlation baroreflex sensitivity: performance on the EUROBAVAR data set","volume":"22","author":"Westerhof","year":"2004","journal-title":"J Hypertens"},{"key":"R16-20230914","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1152\/japplphysiol.01219.2004","article-title":"Orthostatic blood pressure control before and after spaceflight, determined by time-domain baroreflex method","volume":"98","author":"Gisolf","year":"2005","journal-title":"J Appl Physiol (1985)"},{"key":"R17-20230914","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1002\/ana.410110513","article-title":"Convulsive syncope in blood donors","volume":"11","author":"Lin","year":"1982","journal-title":"Ann Neurol"},{"key":"R18-20230914","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S1059-1311(05)80010-X","article-title":"The misdiagnosis of epilepsy: findings of a population study","volume":"7","author":"Scheepers","year":"1998","journal-title":"Seizure"},{"key":"R19-20230914","first-page":"811","article-title":"Electroencephalographic findings during presyncope and syncope induced by tilt table testing","volume":"14","author":"Sheldon","year":"1998","journal-title":"Can J Cardiol"},{"key":"R20-20230914","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1161\/01.STR.29.11.2347","article-title":"Electroencephalographic correlates of vasovagal syncope induced by head-up tilt testing","volume":"29","author":"Ammirati","year":"1998","journal-title":"Stroke"},{"key":"R21-20230914","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1093\/brain\/awt332","article-title":"The semiology of tilt-induced reflex syncope in relation to electroencephalographic changes","volume":"137","author":"van Dijk","year":"2014","journal-title":"Brain"},{"key":"R22-20230914","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.seizure.2015.02.029","article-title":"Semiologic, electroencephalographic and electrocardiographic correlates of seizure-like manifestations caused by cardiac asystole","volume":"29","author":"Jackson","year":"2015","journal-title":"Seizure"},{"key":"R23-20230914","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1016\/S0140-6736(57)92147-5","article-title":"Electro-encephalographic study of syncope; its differentiation from epilepsy","volume":"273","author":"Gastaut","year":"1957","journal-title":"Lancet"},{"key":"R24-20230914","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.seizure.2016.12.002","article-title":"Evaluation of the first seizure patient: key points in the history and physical examination","volume":"49","author":"Nowacki","year":"2017","journal-title":"Seizure"},{"key":"R25-20230914","doi-asserted-by":"crossref","first-page":"77","DOI":"10.3349\/ymj.2010.51.1.77","article-title":"Seizure-like activities during head-up tilt test-induced syncope","volume":"51","author":"Song","year":"2010","journal-title":"Yonsei Med J"},{"key":"R26-20230914","first-page":"28","article-title":"Atrial and ventricular asystole for 19\u200aseconds without syncope. Report of a case","volume":"12","author":"Stern","year":"1976","journal-title":"Isr J Med Sci"},{"key":"R27-20230914","doi-asserted-by":"crossref","first-page":"e11757","DOI":"10.1097\/MD.0000000000011757","article-title":"Electrophysiological mechanisms underlying the Inhibitory CArdiac syncope without asystolic significant pause: therapeutic and prognostic implications. The ELICA randomized trial","volume":"97","author":"Sardu","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"R28-20230914","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.jdiacomp.2014.09.002","article-title":"Autonomic dysfunction is associated with brief episodes of atrial fibrillation in type 2 diabetes","volume":"29","author":"Rizzo","year":"2015","journal-title":"J Diabetes Complications"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00005792-201812210-00047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T20:54:27Z","timestamp":1694724867000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00005792-201812210-00047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12]]},"references-count":28,"journal-issue":{"issue":"51","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000013602","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12]]}}}