Abstracts

Rationale: To investigate whether there is difference of cortical excitability change in epileptic seizure and syncopal attacks, we measured cortical excitability by use transcranial magnetic stimulation (TMS) after each event in patients with loss of consciousness (LOC) due to epileptic seizure and syncopal attack.Methods: We recruited 20 patients with 20 patients with drug-naive first epileptic seizure and 15 patients with syncope and 20 healthy normal controls were enrolled. Resting motor threshold (RMT), motor evoked potential (MEP), cortical silent period (CSP), intracortical inhibition (ICI), intracortical facilitation (ICF) were measured within 24 hour after LOC event in patient with epileptic seizure and syncope, in 7 day later. Results: In 20 patients with epileptic seizure, 13 had partial to secondarily generalized seizure, 7 had idiopathic generalized seizure. MEP and CSP decreased more significantly in epileptic seizure group than in patients with syncope group. After 7 day of events, the decreased parameters in epileptic seizure group normalized and the parameter in syncope group unchanged.Conclusions: Our study showed that cortical excitability transiently decreased after epileptic seizure and unchanged after syncopal attack. these finding suggested the TMS study within 24 hour of loss of consciousness could be useful tool for differentiation between the epileptic seizure and non-epileptic seizure.