Distinguishing Syncope From Seizures: How Useful is the Clinical History?

  • R. S. Sheldon
Conference paper


Transient loss of consciousness is a common clinical problem whose diagnosis frequently poses problems. About 20% of people faint at least once in their lives, probably 10% faint more than once [1], and it is the cause of 1-6% of emergency room visits [2]. The first diagnostic decision to be made is whether the patient has syncope or seizures. Although classic prodromal symptoms, such as convulsive activity, tongue-biting and physical trauma, are often used to diagnose a seizure disorder, this decision-making is based upon historical practice rather than quantitative evidence. The occurrence of convulsive syncope and of akinetic seizures has added to the difficulties of diagnosis. Finally, the pattern of diagnostic features may take several spells to emerge. The reliability of the diagnosis of the first loss of consciousness is surprisingly low [3], but this can be improved with preset diagnostic criteria [4].


Point Score Complete Heart Block Vasovagal Syncope Transient Loss Unexplained Syncope 
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Copyright information

© Springer-Verlag Italia 2004

Authors and Affiliations

  • R. S. Sheldon
    • 1
  1. 1.Cardiovascular Research GroupUniversity of CalgaryAlbertaCanada

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