AccScience Publishing / AN / Volume 1 / Issue 3 / DOI: 10.36922/an.v1i3.140
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CASE REPORT

Vertigo or dizziness as the first presentation of epilepsy: A case report

Ning Wu1 Xiaojun Zhang1 Yanqiang Wang1*
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1 Department of Neurology, The Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, 261 031, China
Advanced Neurology 2022, 1(3), 140 https://doi.org/10.36922/an.v1i3.140
Submitted: 25 June 2022 | Accepted: 3 November 2022 | Published: 29 November 2022
© 2022 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Vertigo or dizziness is a common neurological symptom, but it is rarely regarded as the first presenting symptom of epilepsy. Patients who present with vertigo as the first symptom of epilepsy may be misdiagnosed or missed diagnose. We report a case presenting with vertigo or dizziness as the first manifestation of epilepsy and review relevant literature. A 71-year-old female patient sought medical attention in view of paroxysmal dizziness for a year that progressively worsened over the course of 1 week. Initially, her dizziness occurred 2 or 3 times a month, lasting for less than a minute each time. However, her attacks became more frequent and severe over the course of 1 week. Twenty-four-hour electroencephalogram (EEG) monitoring showed spike-and-slow-wave complex discharges at both sphenoidal electrodes, with the left being more prominent. The patient was treated with oral valproic acid. After a 9-month follow-up, the frequency of dizziness was markedly reduced. Although the pathogenesis of epileptic vertigo remains ambiguous, the current literature indicates that vestibular cortical neurons may be closely associated with periodic abnormal discharge of the brain lobe. Based on comprehensive medical history and EEG results, we should exercise caution when diagnosing this kind of epilepsy.

Keywords
Epilepsy
Vertigo
Dizziness
Electroencephalogram
Funding
Yuan Du Scholars and Weifang Key Laboratory
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Conflict of interest
The authors declare that they have no competing interests.
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Advanced Neurology, Electronic ISSN: 2810-9619 Published by AccScience Publishing