![]() ![]() ![]() The circumstances immediately prior to the attack often suggest a specific aetiology in syncope, much more so than in epilepsy. Obtaining diagnostic clues requires assessing as many events as possible in detail to search for patterns and common features (Colman et al., 2004). Syncope is the subject of this review.Ĭomprehensive medical history taking helps to distinguish the various forms of syncope. In this context, TLOC is the term used to describe a short-lived transient loss of conciousness with spontaneous recovery and syncope is defined as a transient loss of conciousness due to cerebral hypoperfusion (Brignole et al., 2004 Thijs et al., 2004). Profound cerebral hypoperfusion may be accompanied by myoclonic jerks.īlood pressure, cerebral blood flow, syncope, reflex, vasovagal Introductionĭetailed history taking is essential to establish a diagnosis in patients with transient loss of consciousness (TLOC) in particular to distinguish syncope from epilepsy (Hoefnagels et al., 1991 Sheldon et al., 2002 Thijs et al., 2008 b). Complete loss of consciousness occurs with the ‘turning up’ of the eyeballs. abrupt asystole), but in other circumstances it may take longer depending on the rate and depth of cerebral hypoperfusion. This process may take as little as ∼7 s in cases of sudden complete circulatory arrest (e.g. Hearing loss may occur following loss of vision. Narrowing of the field of vision with loss of colour vision (‘greying’ out) and finally a complete loss of vision (hence ‘blacking’ out) occurs. Prior to loss of consciousness the affected individual tends to exhibit unclear thinking, followed by fixation of the eyes in the midline and a ‘frozen’ appearance. A failure of the systemic circulation to perfuse the brain sufficiently results in a stereotyped progression of neurological symptoms and signs culminating in loss of consciousness when transient, this is syncope. In this article the clinical symptoms and signs of the successive phases of a syncopal episode are reviewed. Detailed history taking is of paramount importance to establish a reliable diagnosis in patients with transient loss of consciousness. ![]()
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