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Rehabilitation Practice and Science

Translated Title

腦中風併發抽搞性昏厥之一病例報告

Abstract

Seizure is one of the complications after cerebrovascular accidents, but not all convulsions are epilepsy. Many other diseases such as vasovagal syncope, hypoglycemia and arrhythmia may cause seizure-like episodes. So, we must identify the actual cause to prevent inappropriate treatment.We report a 69 year-old male patient who was asmitted to rehabilitation department due to recurrent cerebrovascular accident with right hemiplegia. Loss of consciousness, myoclonic rhythmic jerk of left arm, upward gazing were noted frequently in upright and sitting position. After return to the lying position, the above symptoms and signs would disappear in few seconds. Antiepileptic dru as given to him but in vain. Tilt table test was performed for this patient. Pallor face, cold sweating, decreased heart rate, decreased blood pressure were noted and followed by myoclonic rhythmic jerk of left arm, upward gazing, loss of consciousness. After tilting table training and elastic bandage usage, the episode of convulsive syncope decreased and the heart rate increased even when his blood pressure dropped. The propose of this casereport is to point out (l) not all seizures are due to epilepsy. Postural hypotention may be resulted in seizure-like episodes (convulsive syncope). (2) Tilt table test is not only a tool for diagnose convulsive syncope but also a tool that can increase the tolerance of patients. Usage of elastic bandage can decrease the venous blood pooling. Combining with tilt table training and usage of elastic bandage can decrease the frequency of convulsive syncope attack.

Language

Traditional Chinese

First Page

163

Last Page

166

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