Obstructive Sleep Apnea: a possible differential diagnosis of epilepsy

Auteurs-es

  • Hajar Maliki Faculté de médecine et de pharmacie de Fès
  • S. LABIED Sleep Medicine Center, Hassan II University Hospital, Fez, Morocco
  • Mohamed chakib Benjelloun Sleep Medicine Center, Hassan II University Hospital, Fez, Morocco
  • Mohamed Elbiaze Sleep Medicine Center, Hassan II University Hospital, Fez, Morocco
  • Zouhayr SOUIRTI Neurology Department, Hassan II University Hospital, Fez, Morocco

Mots-clés :

syncope, obstructive sleep apnea syndrome

Résumé

Introduction

Obstructive sleep apnea syndrome (OSA) is the most common respiratory sleep disorder, although it is overlooked by practitioners. Clinical symptoms may include loud snoring, witnessed apneas, unrefreshing sleep, daytime somnolence, or alteration of cognition. Syncope is a rare mode of revelation of OSA. We report a case of OSA revealed by syncope.

Case report

Mr BM, 52, married who consults for recurrent episodes of loss of consciousness of less than 2 minutes without loss of urine or bite of the tongue. In his history, we find obesity (BMI at 31) and a notion of night snoring. According to his wife's testimony, loss of consciousness occurs mainly in the morning upon waking and after each loss of consciousness, the patient is awakened by auditory stimulation and remembers the episode. The clinical examination did not find any particular anomaly. A syncope of cardiac origin was mentioned given the brief nature of the loss of consciousness and the absence of amnesia of the episode. Cardiac evaluation included holter electrocardiography, stress testing and ambulatory blood pressure monitoring showed no evidence of conduction disorder, arrhythmia, ischemia, or orthostatic fluctuations in blood pressure. he complete electroencephalographic exploration does not reveal any particular anomaly. Biological explorations were normal.
Polysomnography revealed loud snoring with an apnea-hypopnea index of 35 / h dominated by hypopnea events (index at 21.1 / h). The iterative sleep latency test (TILE) revealed an average sleep latency of 9 minutes 36 seconds, without REM sleep.
At the end of these explorations, the diagnosis of OSAS revealed by a syncope was retained. Continuous positive airway pressure therapy has improved symptoms.

Conclusion

Syncope is a rare and unusual presentation of SAOS. The pathophysiological mechanisms of syncope in OSA are not well understood. Screening for OSA should be standard practice in exploring for unexplained syncope.

Bibliographies de l'auteur-e

Hajar Maliki, Faculté de médecine et de pharmacie de Fès

Neurology Department, Hassan II University Hospital, Fez, Morocco

S. LABIED, Sleep Medicine Center, Hassan II University Hospital, Fez, Morocco

Hassan II University Hospital, Fez, Morocco

Mohamed chakib Benjelloun, Sleep Medicine Center, Hassan II University Hospital, Fez, Morocco

Hassan II University Hospital, Fez, Morocco

Mohamed Elbiaze, Sleep Medicine Center, Hassan II University Hospital, Fez, Morocco

Hassan II University Hospital, Fez, Morocco

Zouhayr SOUIRTI, Neurology Department, Hassan II University Hospital, Fez, Morocco

Sleep Medicine Center, Hassan II University Hospital, Fez, Morocco
Neurology Department, Hassan II University Hospital, Fez, Morocco
Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy, University of Sidi Mohamed
Ben Abdellah - Fez, Morocco.

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Publié-e

17-09-2020

Numéro

Rubrique

Brèves Communications