背景：关于在院前环境中早期诊断基底动脉闭塞（BAO）的相关临床发现的证据很少。我们专注于“抽搐样症状”，包括抽搐性癫痫发作和其他类似抽搐的运动，并检查了以这些症状为初始症状的BAO患者的频率和临床特征。
方法：在2015年至2020年的单中心病例系列中，我们确定了接受BAO血管内治疗（EVT）并在中风发作和开始急诊医疗护理之间出现惊厥样症状的患者。通过查看紧急医疗服务和医疗记录的运行表来评估临床病程和神经系统检查结果。
结果：在总共32例BAO患者中，7人（21.9%）在EVT前出现惊厥样症状，其中6人为男性，中位年龄为72岁(四分位数间距，69-78）年。这7例患者均无癫痫或中风史,抽搐样症状的符号学在其中6个中得到了推广。在7个案例中只有3个,紧急医疗服务可以考虑现场中风的可能性，在没有怀疑中风的情况下，从医院到达腹股沟穿刺的时间更长。
结论：21.9%接受EVT治疗的BAO患者最初出现惊厥样症状。在处理老年患者首次出现的全身惊厥样症状时，我们应该警惕BAO的可能性，这可能有助于对急性BAO患者进行充分的分诊和更好的管理。
BACKGROUND: There is little evidence regarding relevant clinical findings for the early diagnosis of basilar artery occlusion (BAO) in the prehospital setting. We focused on \"convulsive-like symptoms\", including convulsive seizures and other convulsive-like movements, and examined the frequency and clinical characteristics of patients with BAO having these symptoms as an initial symptom.
METHODS: In this single-center case series from 2015 to 2020, we identified patients who underwent endovascular therapy (EVT) for BAO and presented with convulsive-like symptoms between the stroke onset and initiation of emergency medical care. The clinical course and neurological findings were evaluated by reviewing the run sheets of emergency medical services and medical records.
RESULTS: Among a total of 32 patients with BAO, 7 (21.9%) developed convulsive-like symptoms before EVT, of whom 6 were men and whose median age was 72 (interquartile range, 69-78) years. These 7 patients had no history of epilepsy or stroke, and the semiology of convulsive-like symptoms was generalized in 6 of them. In only 3 of the 7 cases, emergency medical services could consider the possibility of stroke on scene, and time from hospital arrival to groin puncture was longer in those who were transported without suspicion of stroke.
CONCLUSIONS: 21.9% of our patients who underwent EVT for BAO experienced convulsive-like symptoms initially. We should be vigilant in the possibility of BAO when managing the first-time generalized convulsive-like symptoms occurring in older patients, which may enable to adequate triage and better management for patients with acute BAO.
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