Seizures with an atypical aetiology in an elderly patient: Eagle's syndrome--how does one treat it?

BMJ Case Rep. 2015 Nov 24:2015:bcr2014206136. doi: 10.1136/bcr-2014-206136.

Abstract

Onset of epilepsy can occur at any age, but it is relatively rare in the elderly. Late onset epilepsy is usually secondary to stroke, tumour, trauma or neurodegenerative disorders. A 62-year-old Indian woman presented with frequent drop attacks sometimes leading to unconsciousness and, rarely, associated with seizure. Her epilepsy work up was unremarkable. As the disease progressed, she was diagnosed as having idiopathic epilepsy, syncope or pseudo-seizure, on different occasions, and was treated at length with no response. Finally, detailed history-taking revealed her as having glossopharyngeal neuralgia leading to syncope and seizures. She subsequently improved. In clinical practice, such rare entities should also be considered for proper management of patients' ailments.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Non-Narcotic / therapeutic use
  • Anticonvulsants / therapeutic use
  • Carbamazepine / therapeutic use
  • Diagnosis, Differential
  • Female
  • Glossopharyngeal Nerve / pathology*
  • Humans
  • Medical History Taking
  • Middle Aged
  • Ossification, Heterotopic / complications*
  • Ossification, Heterotopic / diagnosis*
  • Ossification, Heterotopic / physiopathology
  • Pregabalin / therapeutic use
  • Seizures / etiology*
  • Syncope / etiology*
  • Temporal Bone / abnormalities*
  • Temporal Bone / physiopathology
  • Treatment Outcome

Substances

  • Analgesics, Non-Narcotic
  • Anticonvulsants
  • Carbamazepine
  • Pregabalin

Supplementary concepts

  • Eagle syndrome