VERTIGO AS EPILEPTIC SEIZURE MANIFESTATIO N

Vertigo, lightheadedness and dizziness are rare symptoms of focal epil eptic seizures. Vertigo characterized as a sensation of rotational or vertical movement occurs in focal seizures from vestibular cortical ar eas located in the superior temporal gyrus and the area surrounding th e interparietal sulcus. Lightheadedness and dizziness in focal seizure s have limited localizatory value, since they can be observed in seizu res from the frontal and temporal lobe. Seldomly, focal seizures consi st in an isolated sensation of vertigo lasting a few seconds. In gener al, the vertigo is accompanied by additional features as auditory or v isual auras, nystagmus, versive movement or disturbance of consciousne ss. Interictal EEG recordings can reveal focal abnormalities like an u nspecific focal sloeing, rarely including focal epileptiform pattern t hat support the hypothesis of an epileptic origin of the vertigo. The diagnosis of an epileptic seizure can be confirmed by ictal EEG record ings during the vertigo. Radiological imaging techniques, especially t he MRI, are required for the etiological diagnostic. After verificatio n of the epileptic nature of the vertigo and exclusion of a symptomati c brain damage that requires further therapy, anticonvulsive therapy s hould be started according the principles in focal epilepsy. Successfu l treatment in terms of seizure relief can be expected in 50 to 60% of the patients.