Document Detail

Transient loss of consciousness and syncope.
MedLine Citation:
PMID:  24365296     Owner:  NLM     Status:  In-Data-Review    
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 contexts. Management strategies involve pharmacologic and nonpharmacologic interventions, and cardiac pacing.
Claudio L Bassetti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Handbook of clinical neurology     Volume:  119     ISSN:  0072-9752     ISO Abbreviation:  Handb Clin Neurol     Publication Date:  2014  
Date Detail:
Created Date:  2013-12-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0166161     Medline TA:  Handb Clin Neurol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  169-91     Citation Subset:  IM    
Copyright Information:
© 2014 Elsevier B.V. All rights reserved.
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