Epilepsy Research Today is a free monthly online journal that collates and summarizes the latest research about Epilepsy, including details on symptoms, causes, treatment, drugs, information.

Seizure versus syncope.

McKeon A, Vaughan C, Delanty N

Department of Neurology, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin 9, Ireland.

One of the most common but difficult management problems in medicine is that of patients who present with a paroxysmal loss of consciousness. All too often the underlying diagnosis remains elusive. This has a cost both in terms of mortality and ongoing morbidity and in terms of the financial burden associated with hospitalisation and repeated investigations. We describe a practical approach to this clinical dilemma, which is rooted in adherence to basic principles of history taking and examination, formulation of a reasonable differential diagnosis, followed by an intelligent use of specific investigations and selection of an appropriate treatment. We also discuss the effect of sudden unexpected death in epilepsy and sudden cardiac death. Despite a careful and thorough approach to the patient with a "seizure versus syncope" problem, many will require repeated assessment before a diagnosis is made.

Published 23 January 2006 in Lancet Neurol, 5(2): 171-80.
Full-text of this article is available online (may require subscription).

© 2004-2008 Epilepsy Research Today. All Rights Reserved.