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February 1984

Seizures in Paroxysmal Episodes of Unconsciousness

Author Affiliations

F. M. Forster Epilepsy Center William S. Middleton Veterans Administration Hospital Madison, WI 53705

Arch Neurol. 1984;41(2):135-136. doi:10.1001/archneur.1984.04050140033010

To the Editor.  —The article on paroxysmal episodes of unconsciousness secondary to a syrinx by McComas et al1 was instructive. However, we are sorry that they neither expanded the differential diagnosis to include explicitly seizures as the cause for their patient's loss of consciousness nor performed an EEG. We report a case of unconsciousness involving seizure.

Report of a Case.  —A 31-year-old man was involved in an automobile accident and rendered temporarily unconscious. He sustained a C5-6 quadraplegia that persisted. The patient subsequently experienced several episodes per year of nausea, occasional vomiting, frequent coughing or choking, and then loss of consciousness. During these episodes, there was tongue biting, and the eyes rolled upward. His unconsciousness lasted several minutes, and afterwards, he was tired. More frequently, the patient had just episodes of nausea, with some of the other milder symptoms. Initially, this condition was ignored, but it was later given

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