Epileptic fit as a syncope equivalent in severe aortic stenosis.

Overview

The case report of a patient suffering from dyspnea and chest pain together with a history of repetitive epileptic paroxysms within the past few months is presented. The epileptic fits were also registered during his hospital stay. Transthoracic echocardiography proved moderate left ventricular dysfunction (ejection fraction 33 %) and severe aortic valve stenosis (peak pressure gradient 102 mmHg, aortic valve area 0.45 cm2). The epileptic fits were also documented by electroencephalography (EEG) and a transcranial Doppler study detected reduced blood flow within the intracerebral arteries. The patient underwent successful cardiosurgery to replace the stenotic aortic valve with a mechanical prothesis (SJM Regent 25 mm). Myocardial function showed marked improvement (EF 50 %) following the procedure. Repeated EEG examination exhibited completely normal findings. At present, the patient remains in good health without any epileptic fits. We consider the case of aortic stenosis inducing epileptic symptoms caused by transient cerebral ischemiaextremely rare and informative for general practitioners and other physicians.

Key words:
severe aortic stenosis, secondary epilepsy.