Takayasu's disease presenting as convulsive syncope which had been misinterpreted as epilepsy: a case report

INTRODUCTION: Takayasu's arteritis is a chronic vasculitis mainly involving the aorta and its main branches. The disease has protean clinical manifestation ranging from asymptomatic to catastrophic illness. CASE PRESENTATION: A 19-year-old woman of Asian origin was referred to our neurology out-patient department for the management of refractory seizures. She reported several episodes of a loss of consciousness with tonic posturing when she assumed an upright position, which was accompanied by constitutional symptoms. A clinical examination showed orthostatic hypotension and an investigation confirmed the diagnosis of Takayasu's disease with presentation as convulsive syncope. CONCLUSION: Our case highlights the importance of a thorough clinical history and physical examination in order to distinguish events mimicking epileptic seizure. We also describe an unusual presentation of Takayasu's disease with convulsive syncope and systemic constitutional symptoms.