Meryem BAKIR, Murat GÖNEN, Caner Feyzi DEMİR, Ferhat BALGETİR, İrem TAŞCI, İbrahim BEYDILLI

Glossofarengeal nevraljinin tetiklediği senkopal konvülziyon olgusu

Senkopal konvülziyonların ve epileptik nöbetlerin klinik olarak ayırtedilmesi zordur ve tedavi yaklaşımları farklılık gösterir. Antiepileptik tedaviye dirençli konvülziyonların ayırıcı tanısında serebral perfüzyonu bozan kardiyak aritmileri düşünmek önemlidir. Bu yazıda, yutkunma ile ilişkili tekrarlayan senkopal konvülsiyon atakları olan 72 yaşındaki glossofarengeal nevraljili erkek hasta sunuldu. Hasta geçici kalp pili ve karbamazepin ile başarılı bir şekilde tedavi edildi. Bu olgu, epileptik nöbetlerin ayırıcı tanısında nadir görülen glossopharengial nevralji ve buna bağlı asistolinin tetiklediği senkopal konvülziyonlara dikkat çekmektedir.

A case of syncopal convulsions triggered by glossopharyngeal neuralgia

Syncopal convulsions and epileptic seizures are clinically hard to distinguish and differ in terms of treatment approaches. Itis important to consider the cardiac arrhythmias that impair cerebral perfusion in the differential diagnosis of antiepileptictreatment-resistant convulsions. Here, we offer a 72-year-old male patient glossopharyngeal neuralgia (GN) after swallowingassociated with recurrent episodes of syncopal convulsions. The patient was successfully treated with temporary pacemakerand carbamazepine. This phenomenon is noteworthy in terms of both asystole triggered by GN and syncopal convulsionswhich are rare in the differential diagnosis of epileptic seizures.

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1. Blumenfeld A, Nikolskaya G. Glossopharyngeal neuralgia. Curr Pain Headache Rep 2013;17(7):343. [CrossRef ]
2. Kapoor WN. Syncope. N Engl J Med 2000;343:1856. [CrossRef]
3. Lin JT, Ziegler DK, Lai CW, Bayer W. Convulsive syncope in blood donors. Ann Neurol 1982;11(5):525–8. [CrossRef ]
4. Rushton JG, Stevens JC, Miller RH. Glossopharyngeal (vagoglossopharyngeal) neuralgia: A study of 217 cases. Arch Neurol 1981;38(4):201–5. [CrossRef ]
5. Bradley WG, Daroff RB, Fenichel GM, Jankovic J. Otonom sinir sistemi hastalıkları. In: Tan E, Ozdamar SE, editors. Neurology in Clinical Practice. Ankara: Veri Medikal Yayıncılık; 2008. p. 2376.
6. Barbash GI, Keren G, Korczyn AD, Sharpless NS, Chayen M, Copperman Y, et al. Mechanisms of syncope in glossopharyngeal neuralgia. Clin Neurophysiol 1986;63(3):231– 5. [CrossRef ]
7. Den Hartog AW, Jansen E, Kal JE, Duyndam D, Visser J, Van Den Munckhof P, et al. Recurrent syncope due to glossopharyngeal neuralgia. Heart Rhythm Case Rep 2017;3(1):73–7. [CrossRef ]
8. Lempert T, Bauer M, Schmidth D. Syncope: A videometric analysis of 56 episodes of transient cerebral hypoxia. Ann Neurol 1994;36(2):233–7. [CrossRef ]
9. Burfield L, Ahmad F, Adams J. Glossopharyngeal neuralgia associated with cardiac syncope. BMC Case Rep 2016;2016:bcr2015214104. [CrossRef ]
10. Reed RL, Siekert RG, Merideth J. Rarity of transient focal cerebral ischemia in cardiac dysrhythmia. JAMA 1973;223:893–95. [CrossRef ]
11. Bora I, Yeni SN, Gürses C. Epilepsi. 1st ed. İstanbul: Nobel Kitabevleri; 2008.
12. Sheldon R, Rose S, Ritchie D, Connolly SJ, Koshman ML, Lee MA, et al. Historical criteria that distinguish syncope from seizures. J Am Coll Cardiol 2002;40:142–8. [CrossRef ]
13. Johnston RT, Redding VJ. Glossopharyngeal neuralgia associated with cardiac syncope: Long term treatment with permanent pacing and carbamazepine. Br Heart J 1990;64(6):403–5. [CrossRef ]
14. Khero BA, Mullins CB. Cardiac syncope due to glossopharyngeal neuralgia treatment with transvenous pacemaker. Arch Intern Med 1971;128(5):806–8. [CrossRef ]