Tilt table testing in patients with suspected epilepsy


R. Edfors, Medical Department, Bornholm Hospital, Roenne, Denmark
Tel.: +45 56951165
Fax: +45 56927621
e-mail: edfors@gmail.com


Background –  Approximately 20–30% of patients with epilepsy are misdiagnosed and syncope often seems to be the mistaken cause. We re-evaluated patients referred to an epilepsy clinic where suspicion of neurally mediated (reflex) syncope were raised using tilt table testing (HUT).

Methods –  HUT laboratory results and medical records of 120 consecutive patients were reviewed retrospectively over a period of 27 months.

Results –  HUT was positive in 59 (49%) patients. Seventeen of 38 (45%) patients previously diagnosed with epilepsy and taking antiepileptic drugs were found to be misdiagnosed. Four of 21 patients with epilepsy (19%) had dual diagnoses of reflex syncope and epilepsy.

Conclusion –  HUT is an informative investigation when suspicions of reflex syncope are raised in patients referred to an epilepsy clinic. Reflex syncope is an important and common differential diagnosis of epilepsy.