Transient loss of consciousness and syncope

Handbook of Clinical Neurology
Claudio L Bassetti

Abstract

Syncope describes a sudden and brief transient loss of consciousness (TLOC) with postural failure due to cerebral global hypoperfusion. The term TLOC is used when the cause is either unrelated to cerebral hypoperfusion or is unknown. The most common causes of syncopal TLOC include: (1) cardiogenic syncope (cardiac arrhythmias, structural cardiac diseases, others); (2) orthostatic hypotension (due to drugs, hypovolemia, primary or secondary autonomic failure, others); (3) neurally mediated syncope (cardioinhibitory, vasodepressor, and mixed forms). Rarely neurologic disorders (such as epilepsy, transient ischemic attacks, and the subclavian steal syndrome) can lead to cerebal hypoperfusion and syncope. Nonsyncopal TLOC may be due to neurologic (epilepsy, sleep attacks, and other states with fluctuating vigilance), medical (hypoglycemia, drugs), psychiatric, or post-traumatic disorders. Basic diagnostic workup of TLOC includes a thorough history and physical examination, and a 12-lead electrocardiogram (ECG). Blood testing, electroencephalogram (EEG), magnetic resonance imaging (MRI) of the brain, echocardiography, head-up tilt test, carotid sinus massage, Holter monitoring, and loop recorders should be obtained only in specific ...Continue Reading

Citations

Jan 24, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A LabateA Gambardella
Sep 27, 2015·Internal and Emergency Medicine·Davide CampagnaRiccardo Polosa
Jul 18, 2018·Medizinische Klinik, Intensivmedizin und Notfallmedizin·C KillE Bösl
Feb 6, 2018·The Journal of Veterinary Medical Science·Ryuji FukushimaNoboru Machida
Jul 22, 2019·Nature Reviews. Neurology·Claudio L A BassettiYves Dauvilliers
Jan 7, 2016·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ayşe Kaçar BayramHuseyin Per

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