Syncopal attacks compulsively self-induced by Valsalva's maneuver associated with typical absence seizures. A case report

Arch Neurol. 1988 Aug;45(8):923-5. doi: 10.1001/archneur.1988.00520320125029.


A girl of borderline intelligence developed repeated syncopal attacks that were compulsively self-induced, apparently by forced expiration against a closed glottis (Valsalva's maneuver). In addition, she had typical absence seizures triggered by her apneic attacks, which could also be induced by hyperventilation. The absence seizures were suppressed by treatment with valproate sodium, which had no effect on the self-induced apneas. These were considerably improved with fenfluramine hydrochloride treatment, which was also associated with marked improvement of her previously abnormal behavior.

Publication types

  • Case Reports

MeSH terms

  • Apnea / drug therapy
  • Apnea / etiology*
  • Child
  • Child Behavior / drug effects
  • Compulsive Behavior*
  • Electroencephalography
  • Epilepsy, Absence / complications*
  • Epilepsy, Absence / drug therapy
  • Epilepsy, Absence / physiopathology
  • Female
  • Fenfluramine / therapeutic use
  • Humans
  • Syncope / etiology*
  • Valproic Acid / therapeutic use
  • Valsalva Maneuver*


  • Fenfluramine
  • Valproic Acid