Combined electroencephalography and measurements of transcranial blood flow velocity during orthostatic testing - A new approach to assess syncope of unknown origin?

S. Ladwig, S. Ries, O. Henning, A. Valikovics, M. Daffertshofer, B. Pohlmann-Eden

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Differential diagnosis of syncope and seizures frequently imposes a major problem, particularly if interictal examinations are normal. We performed orthostatic testing combined with surface electroencephalography (EEG) and non-invasive measurements of cerebral blood flow velocity. Ten healthy controls, ten patients with confirmed diagnosis of epilepsy and 25 patients with history of syncope of unknown origin were examined. The following parameters were evaluated continuously and simultaneously during orthostatic challenge: computerized EEG with synchronous video-monitoring, transcranial Doppler sonography (TCD), heart rate and blood pressure. Isolated cerebrovascular dysregulation (i.e. a drop in cerebral perfusion despite the absence of a significant drop in peripheral blood pressure) occurred in 2/10 controls, 3/10 patients with epilepsy and 11/25 patients with syncope of unknown origin. The combined EEG and TCD measurements represent a new approach to the work-up of patients with otherwise unexplained syncope, helping us to understand the interdependence of neuronal activity and peripheral/cerebrovascular autoregulation under postural stress.

Original languageEnglish
Pages (from-to)305-309
Number of pages5
JournalClinical Autonomic Research
Volume7
Issue number6
DOIs
Publication statusPublished - Jan 1 1997

Keywords

  • Cerebral hemodynamics
  • Cerebrovascular autoregulation
  • Isolated cerebrovascular dysregulation
  • Multimodal tilt-table test
  • Orthostatic dysregulation

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology

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