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Advanced Neurology

CASE REPORT
Vertigo or dizziness as the first presentation of

epilepsy: A case report

Ning Wu, Xiaojun Zhang, and Yanqiang Wang*
Department of Neurology, The Affiliated Hospital of Weifang Medical University, Weifang, Shandong
Province, 261 031, China

Abstract
Vertigo or dizziness is a common neurological symptom, but it is rarely regarded as
the first presenting symptom of epilepsy. Patients who present with vertigo as the
first symptom of epilepsy may be misdiagnosed or missed diagnose. We report a
case presenting with vertigo or dizziness as the first manifestation of epilepsy and
review relevant literature. A 71-year-old female patient sought medical attention in
view of paroxysmal dizziness for a year that progressively worsened over the course
of 1 week. Initially, her dizziness occurred 2 or 3 times a month, lasting for less than a
minute each time. However, her attacks became more frequent and severe over the
course of 1 week. Twenty-four-hour electroencephalogram (EEG) monitoring showed
spike-and-slow-wave complex discharges at both sphenoidal electrodes, with the
left being more prominent. The patient was treated with oral valproic acid. After a
9-month follow-up, the frequency of dizziness was markedly reduced. Although the
pathogenesis of epileptic vertigo remains ambiguous, the current literature indicates
that vestibular cortical neurons may be closely associated with periodic abnormal
discharge of the brain lobe. Based on comprehensive medical history and EEG results,
*Corresponding author: we should exercise caution when diagnosing this kind of epilepsy.
Yanqiang Wang
(wangqiangdoctor@126.com)
Citation: Wu N, Zhang X, Wang Y, Keywords: Epilepsy; Vertigo; Dizziness; Electroencephalogram
2022, Vertigo or dizziness as the
first presentation of epilepsy: A case
report. Adv Neuro, 1(3): 140.
https://doi.org/10.36922/an.v1i3.140 1. Background
Received: June 25, 2022
Vertigo or dizziness is a common neurological symptom that is related to peripheral
Accepted: November 3, 2022 and/or central nervous system disorders. The vestibular system extends from the
Published Online: November 29, peripheral vestibular part of the inner ear to the brainstem and cerebral cortex. Any
2022 lesion throughout the entire tract could lead to dizziness or vertigo. A growing number
Copyright: © 2022 Author(s). of literature has suggested that vertigo or dizziness is deemed as one of the clinical
This is an Open Access article manifestations of epileptic seizures . Especially the focal and intermittent epileptic
[1]
distributed under the terms of the
[2]
Creative Commons Attribution discharges, which are accompanied by episodic vestibular symptoms , have been
License, permitting distribution, referred to as vertiginous seizures, epileptic vertigo or dizziness (EVD), vestibular
and reproduction in any medium, [3-6]
provided the original work is epilepsy or seizures, and so on . Herein, we report a case presenting with vertigo or
properly cited. dizziness as the first manifestation of epilepsy and review relevant literature.
Publisher’s Note: AccScience
Publishing remains neutral with 2. Case presentation
regard to jurisdictional claims in
published maps and institutional A 71-year-old female patient presented to our hospital in August 2016 in view of
affiliations. paroxysmal dizziness for a year that progressively worsened over a week, accompanied

Volume 1 Issue 3 (2022) 1 https://doi.org/10.36922/an.v1i3.140