Background: Epileptic vertigo is a rare form of partial seizures. It is often distinctive with sudden very brief episodes followed by rapid recovery without sequelae. Objective: Of this study was to establish the contribution of clinical semiology of epileptic vertigo in absence of convulsions and loss of consciousness. Patients and Methods: Thirty epileptic vertigo patients (19 males and 11 females) were included. Their ages ranged from 12 to 40 years and mean age at onset 26.7 years. All patients were subjected to neurological examination, interictal electroencephalogram (EEG), caloric otologic test, audiogram, nystagmography, carotid Doppler; brain stem evoked potential and brain MRI. Results: Family history of epilepsy was reported in 20%, no past history of febrile convulsion, tunnel voices aura was reported in 6.7%. Dizziness was report in 8 patients (26.7%), 14 patients with true vertigo (46.6%), nausea in 6 (20%) and tinnitus in 2 patients (6.7%). EEG abnormality was documented in all cases: Fifteen (50%) and 6 (20%) patients illustrated focal left and right temporal epileptiform discharges consecutively. In addition, there were bitemporal 2 (6.7%), 2 (6.7 %) frontotemporal and 5 cases (16.8%) temporal with secondary generalization discharges. MRI of brain was normal in 20 (66.6%), 4 cases with temporal lobe tumors, cerebral infarction was in one and small cyst. Frontal lobe lesions were detected in 4 patients. No mesial temporal sclerosis was detected. Conclusion: Epilepsy is an important cause of transient dizziness and vertigo, but misdiagnosis due to absence of convulsions and loss of consciousness, is common. [Egypt J Neurol Psychiat Neurosurg. 2011; 48(1): 31-36]
Key Words: Epilepsy, Epileptic vertigo, EEG in epileptic vertigo
Correspondence to Mohamed Saad. Department of Neurology, Mansoura University, 35516 EL-Jomhoria st. Mansoura, Egypt.
Email; prof_mohamedsaad@yahoo.com