Chapter 3 - Syncope

Summary

This chapter describes the clinical characteristics of syncope and its distinction from generalized tonic-clonic seizures, which cause the most difficulties in daily clinical practice. The high variability of frequencies at which convulsions in syncope were observed is explained by their highly variable presentation. The most important criterion to differentiate syncopal and epileptic convulsions is their specific phenomenology. Presyncope is the prodromal stage of syncope in which there is only a less pronounced hypoperfusion of the brain and therefore no complete loss of consciousness. Syncope can also appear after eating a carbohydrate-rich meal, particularly in elderly patients. Syncope associated with migraine is particularly frequent in basilar migraine. This form of migraine occurs mostly in adolescent girls and young women. The initial evaluation of a patient presenting after loss of consciousness includes a thorough history, a physical examination, supine and upright measurement of blood pressure and pulse rate, and an electrocardiogram (ECG).