Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2022; 10(31): 11542-11548
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11542
Aortic dissection with epileptic seizure: A case report
Bo Zheng, Xue-Qiong Huang, Zhao Chen, Jian Wang, Gang-Feng Gu, Xiao-Jing Luo
Bo Zheng, Zhao Chen, Jian Wang, Gang-Feng Gu, Xiao-Jing Luo, Department of Neurology, Yaan People’s Hospital, Yaan 625000, Sichuan Province, China
Xue-Qiong Huang, Department of Oncology, Yaan People’s Hospital, Yaan 625000, Sichuan Province, China
Author contributions: Zheng B, Huang XQ, Wang J, and Gu GF reviewed the literature and contributed to manuscript drafting; Chen Z analyzed and interpreted the imaging findings; Luo XJ was responsible for the revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Supported by the Sichuan Provincial Science and Technology Department, No. 2019ZYZF0063, and No. 2020YJ0497; the Sichuan Medical Association, No. Q21049; and the Key Technology Plan of Yaan City, No. 21KJH0006.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Wang, MD, Doctor, Department of Neurology, Yaan People’s Hospital, No. 358 Chenghou Road, Yaan 625000, Sichuan Province, China. wangjian0724@126.com
Received: June 2, 2022
Peer-review started: June 2, 2022
First decision: August 22, 2022
Revised: August 30, 2022
Accepted: October 9, 2022
Article in press: October 9, 2022
Published online: November 6, 2022
Abstract
BACKGROUND

Aortic dissection (AoD) is a life-threatening disease. Its diversified clinical manifestations, especially the atypical ones, make it difficult to diagnose. The epileptic seizure is a neurological problem caused by various kinds of diseases, but AoD with epileptic seizure as the first symptom is rare.

CASE SUMMARY

A 53-year-old male patient suffered from loss of consciousness for 1 h and tonic-clonic convulsion for 2 min. The patient performed persistent hypomania and chest discomfort for 30 min after admission. He had a history of hypertension without regular antihypertensive drugs, and the results of his bilateral blood pressure varied greatly. Then the electroencephalogram showed the existence of epileptic waves. The thoracic aorta computed tomography angiography showed the appearance of AoD, and it originated at the lower part of the ascending aorta. Finally, the diagnosis was AoD (DeBakey, type I), acute aortic syndrome, hypertension (Grade 3), and secondary epileptic seizure. He was given symptomatic treatment to relieve symptoms and prevent complications. Thereafter, the medical therapy was effective but he refused our surgical advice.

CONCLUSION

The AoD symptoms are varied. When diagnosing the epileptic seizure etiologically, AoD is important to consider by clinical and imaging examinations.

Keywords: Aortic dissection, Epileptic seizure, Hypertension, Diagnosis, Surgical treatment, Case report

Core Tip: The clinical manifestations of aortic dissection (AoD) are diverse. AoD with epileptic seizure as the first symptom is rare. Measuring blood pressure and image analysis are important to diagnose. In conclusion, it is important to consider AoD when diagnosing epileptic seizure, and surgical treatment is an important option under the right conditions.