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By Tarakad S Ramachandran MD and Arun Ramachandran MD

Syncope is also known as or subsumes Stokes-Adams attack. –ed

Syncope can be defined as transient loss of consciousness with loss of postural tone. To start with, affected individuals tend to exhibit unclear thinking, followed by fixation of the eyes in the midline and a “frozen” appearance. Narrowing of the field of vision and loss of color vision (graying out) occur, followed by complete loss of vision, loss of consciousness, turning up of the eyeballs, and, when severe, myoclonic jerks. Although the treatment of neurologic or cardiac syncope aims at the underlying cause, the primary treatment of neurovascular syncope consists of patient education and instruction in reasonable precautions.

Key Points

  • Syncope is a prevalent disorder, accounting for 3% to 5% of emergency department visits and 1% to 3% of hospital admissions.
  • Syncope may be confused with seizure, cryptogenic drop attacks, migraine, basilar thrombosis, or metabolic disturbances.
  • Unlike true episodes of syncope, episodes of pseudosyncope are not associated with compromised cerebral circulation.
  • In addition to a predisposition to fainting spells, a significant portion of children with breath-holding spells have concentration problems.
  • The 2nd Consensus Committee on Bradada Syndrome recommends an implantable cardioverter-defibrillator in all patients with syncope without a "clear extracardiac cause."

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited