Pre SAMMPRIS: A case recurrent convulsive syncope in a patient with bilateral carotid stenosis secondary to giant cell arteritis with complete recovery after angioplasty

4^th International Conference on Central Nervous System Disorders & Therapeutics

November 12-13, 2018 | Edinburgh, Scotland

Mervat Wahba

University of Tennessee Health Science Center, Memphis, USA

Scientific Tracks Abstracts: J Neurol Disord

Abstract :

Significance: This case illustrates that giant cell arteritis (GCA) is a potentially fatal disease. The carotid arteries may be affected early and selectively. The carotid siphon and supraclinoid parts may be affected selectively without affecting the cervical carotid parts. Carotid artery stenosis may be evidenced not by a stroke, but by other neurological deficits such as �??drop attacks�?� or �??convulsive syncope�?�. Occlusive lesions of the internal carotid artery (ICA) constitute the commonest cause of cerebrovascular accidents. They are usually atherosclerotic in origin, although occasionally other causes such as dissection, fibromuscular dysplasia, or vasculitic process may be etiogenic. Bilateral ICA stenosis is a particularly devastating condition with an annual stroke rate of 7.6% per year and an annual mortality of 43%. History: A 63-year-old man presented with recurrent spells of falling to the ground triggered by an upright position. This may be associated with shaking of the extremities. No epileptogenic or cardiac etiology was found. A CT angiogram showed over 90% stenosis of the bilateral internal carotid arteries at the siphon. He was recently diagnosed with giant cell arteritis. He was placed on prednisone. Conclusion: The presence of bilateral carotid stenosis in patients with GCA is strongly associated with future risk of neurologic deficits. It may be difficult to separate atherosclerotic lesions from vasculitic lesions related to GCA. However, the presence of localized focal stenosis with relatively healthy arteries above and below the lesions may point to a vasculitic process. Rigorous attention should be given to modification of atherosclerotic risk factors as well as recognizing and treating the rare manifestation of GCA.

Biography :

Mervat Wahba is a Neurologist in Memphis, Tennessee and is affiliated with multiple hospitals in the area, including Baptist Memorial Hospital-Memphis and Methodist Hospitals of Memphis. She received her Medical Degree from Cairo University, School of Medicine and has been in practice for more than 20 years. She is one of the 62 doctors at Baptist Memorial Hospital-Memphis and one of 52 at Methodist Hospitals of Memphis who specialize in Neurology.

E-mail: mervatwahba@outlook.com