Vertigo or dizziness as the first presentation of epilepsy: A case report

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.