How to differentiate syncope from seizure

Cardiac Electrophysiology Clinics

Volumn 5, Issue 4, 2013, Pages 423-431

  Sheldon, Robert ^a  

^a UNIVERSITY OF CALGARY   (Canada)

Author keywords

Convulsive syncope; Epileptic seizures; Syncope; Tilt tests

Indexed keywords

CONVULSIVE SYNCOPE; DIAGNOSTIC ACCURACY; DIAGNOSTIC ERROR; ELECTROENCEPHALOGRAM; FAINTNESS; HEALTH CARE DELIVERY; HEALTH SERVICE; HUMAN; IMPLANTABLE CARDIAC MONITOR; PREVALENCE; PRIORITY JOURNAL; REVIEW; SEIZURE; TILT TABLE TEST; UNCONSCIOUSNESS; VIDEORECORDING;

EID: 84887616472     PISSN: 18779182     EISSN: 18779190     Source Type: Journal    
DOI: 10.1016/j.ccep.2013.08.004     Document Type: Review

References (51)

1. Moya A., Sutton R., Ammirati F., et al. Guidelines for the diagnosis and management of syncope (version 2009): the Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC). Eur Heart J 2009, 30:2631-2671.
2. McKeon A., Vaughan C., Delanty N. Seizure versus syncope. Lancet Neurol 2006, 5:171-180.
3. Ammirati F., Colaceci R., Cesario A., et al. Management of syncope: clinical and economic impact of a syncope unit. Europace 2008, 10:471-476.
4. Baron-Esquivias G., Moreno S.G., Martinez A., et al. Cost of diagnosis and treatment of syncope in patients admitted to a cardiology unit. Europace 2006, 8:122-127.
5. Bartoletti A., Fabiani P., Adriani P., et al. Hospital admission of patients referred to the emergency department for syncope: a single-hospital prospective study based on the application of the European Society of Cardiology Guidelines on syncope. Eur Heart J 2006, 27:83-88.
6. Krahn A.D., Klein G.J., Yee R., et al. Cost implications of testing strategy in patients with syncope: randomized assessment of syncope trial. JAm Coll Cardiol 2003, 42:495-501.
7. Sun B.C., Emond J.A., Camargo C.A. Direct medical costs of syncope-related hospitalizations in the United States. Am J Cardiol 2005, 95:668-671.
8. Hirano Y., Oguni H., Osawa M. Epileptic negative drop attacks in atypical benign partial epilepsy: a neurophysiological study. Epileptic Disord 2009, 11:37-41.
9. Banerjee P.N., Filippi D., Hauser W.A. The descriptive epidemiology of epilepsy: a review. Epilepsy Res 2009, 85:31-45.
10. Sheldon R., Rose S., Ritchie D., et al. Historical criteria that distinguish syncope from seizures. JAm Coll Cardiol 2002, 40:142-148.
11. Savage D.D., Corwin L., McGee D.L., et al. I- epidemiologic features of isolated syncope: the Framingham Study. Stroke 1985, 16:626-629.
12. Ganzeboom K.S., Mairuhu G., Reitsma J.B., et al. Lifetime cumulative incidence of syncope in the general population: a study of 549 Dutch subjects aged 35-60 years. JCardiovasc Electrophysiol 2006, 17:1172-1176.
13. Serletis A., Rose S., Sheldon A.G., et al. Vasovagal syncope in medical students and their first-degree relatives. Eur Heart J 2006, 27:1965-1970.
14. Ganzeboom K.S., Colman N., Reitsma J.B., et al. Prevalence and triggers of syncope in medical students. Am J Cardiol 2003, 91:1006-1008. A8.
15. Sheldon R.S., Morillo C.A., Krahn A.D., et al. Standardized approaches to the investigation of syncope: Canadian Cardiovascular Society position paper. Can J Cardiol 2011, 27:246-253.
16. Soteriades E.S., Evans J.C., Larson M.G., et al. Incidence and prognosis of syncope. NEngl J Med 2002, 347:878-885.
17. Wieling W., Krediet C.T., van Dijk N., et al. Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (Lond) 2007, 112:157-165.
18. Sheldon R., Rose S., Connolly S., et al. Diagnostic criteria for vasovagal syncope based on a quantitative history. Eur Heart J 2006, 27:344-350.
19. Sud S., Massel D., Klein G.J., et al. The expectation effect and cardiac pacing for refractory vasovagal syncope. Am J Med 2007, 120:54-62.
20. Kanjwal K., Kanjwal Y., Karabin B. Clinical symptoms associated with asystolic or bradycardic responses on implantable loop recorder monitoring in patients with recurrent syncope. Int J Med Sci 2009, 6:106-110.
21. Calkins H., Shyr Y., Frumin H., et al. The value of the clinical history in the differentiation of syncope due to ventricular tachycardia, atrioventricular block, and neurocardiogenic syncope. Am J Med 1995, 98:365-373.
22. Lin J.T., Ziegler D.K., Lai C.W., et al. Convulsive syncope in blood donors. Ann Neurol 1982, 11:525-528.
23. Song P.S., Kim J.S., Park J., et al. Seizure-like activities during head-up tilt test-induced syncope. Yonsei Med J 2010, 51:77-81.
24. Passman R., Horvath G., Thomas J., et al. Clinical spectrum and prevalence of neurologic events provoked by tilt table testing. Arch Intern Med 2003, 163:1945-1948.
25. Zaidi A., Clough P., Cooper P., et al. Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause. JAm Coll Cardiol 2000, 36:181-184.
26. Petkar S., Hamid T., Iddon P., et al. Prolonged implantable electrocardiographic monitoring indicates a high rate of misdiagnosis of epilepsy: REVISE study. Europace 2012, 14:1653-1660.
27. Kanjwal K., Karabin B., Kanjwal Y., et al. Differentiation of convulsive syncope from epilepsy with an implantable loop recorder. Int J Med Sci 2009, 6:296-300.
28. Lempert T., Bauer M., Schmidt D. Syncope: a videometric analysis of 56 episodes of transient cerebral hypoxia. Ann Neurol 1994, 36:233-237.
29. Josephson C.B., Rahey S., Sadler R.M. Neurocardiogenic syncope: frequency and consequences of its misdiagnosis as epilepsy. Can J Neurol Sci 2007, 34:221-224.
30. Smith D., Defalla B.A., Chadwick D.W. The misdiagnosis of epilepsy and the management of refractory epilepsy in a specialist clinic. QJM 1999, 92:15-23.
31. Chowdhury F.A., Nashef L., Elwes R.D. Misdiagnosis in epilepsy: a review and recognition of diagnostic uncertainty. Eur J Neurol 2008, 15:1034-1042.
32. van Donselaar C.A., Geerts A.T., Meulstee J., et al. Reliability of the diagnosis of a first seizure. Neurology 1989, 39:267-271.
33. Alboni P., Brignole M., Menozzi C., et al. Diagnostic value of history in patients with syncope with or without heart disease. JAm Coll Cardiol 2001, 37:1921-1928.
34. Sheldon R., Hersi A., Ritchie D., et al. Syncope and structural heart disease: historical criteria for vasovagal syncope and ventricular tachycardia. JCardiovasc Electrophysiol 2010, 21:1358-1364.
35. Sabri M.R., Mahmodian T., Sadri H. Usefulness of the head-up tilt test in distinguishing neurally mediated syncope and epilepsy in children aged 5-20 years old. Pediatr Cardiol 2006, 27:600-603.
36. Grubb B.P., Gerard G., Roush K., et al. Differentiation of convulsive syncope and epilepsy with head-up tilt testing. Ann Intern Med 1991, 115:871-876.
37. Sheldon R.S., Koshman M.L., Murphy W.F. Electroencephalographic findings during presyncope and syncope induced by tilt table testing. Can J Cardiol 1998, 14:811-816.
38. Sheldon R. Tilt testing for syncope: a reappraisal. Curr Opin Cardiol 2005, 20:38-41.
39. Benbadis S.R., Chichkova R. Psychogenic pseudosyncope: an underestimated and provable diagnosis. Epilepsy Behav 2006, 9:106-110.
40. Chung S.S., Gerber P., Kirlin K.A. Ictal eye closure is a reliable indicator for psychogenic nonepileptic seizures. Neurology 2006, 66:1730-1731.
41. Hubsch C., Baumann C., Hingray C., et al. Clinical classification of psychogenic non-epileptic seizures based on video-EEG analysis and automatic clustering. JNeurol Neurosurg Psychiatr 2011, 82:955-960.
42. Luzza F., Di Rosa S., Pugliatti P., et al. Syncope of psychiatric origin. Clin Auton Res 2004, 14:26-29.
43. Yilmaz S., Gokben S., Levent E., et al. Syncope or seizure? The diagnostic value of synchronous tilt testing and video-EEG monitoring in children with transient loss of consciousness. Epilepsy Behav 2012, 24:93-96.
44. Brignole M., Vardas P., Hoffman E., et al. Indications for the use of diagnostic implantable and external ECG loop recorders. Europace 2009, 11:671-687.
45. Farwell D.J., Freemantle N., Sulke A.N. Use of implantable loop recorders in the diagnosis and management of syncope. Eur Heart J 2004, 25:1257-1263.
46. Allcock L.M., O'Shea D. Diagnostic yield and development of a neurocardiovascular investigation unit for older adults in a district hospital. JGerontol A Biol Sci Med Sci 2000, 55:M458-M462.
47. Dey A.B., Bexton R.S., Tyman M.M., et al. The impact of a dedicated "syncope and falls" clinic on pacing practice in northeastern England. Pacing Clin Electrophysiol 1997, 20:815-817.
48. Kenny R.A., O'Shea D., Walker H.F. Impact of a dedicated syncope and falls facility for older adults on emergency beds. Age Ageing 2002, 31:272-275.
49. McIntosh S., Da Costa D., Kenny R.A. Outcome of an integrated approach to the investigation of dizziness, falls and syncope in elderly patients referred to a 'syncope' clinic. Age Ageing 1993, 22:53-58.
50. Brignole M., Disertori M., Menozzi C., et al. Management of syncope referred urgently to general hospitals with and without syncope units. Europace 2003, 5:293-298.
51. Shen W.K., Decker W.W., Smars P.A., et al. Syncope Evaluation in the Emergency Department Study (SEEDS): a multidisciplinary approach to syncope management. Circulation 2004, 110:3636-3645.