Epileptic Seizures Versus Syncope: Pathophysiology and Clinical Approach

  • Marios Charalambous UCL Institute of Neurology, Faculty of Brain Sciences, University College London, United Kingdom
  • Sergio A. Gomes Queen’s Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, United Kingdom
  • Stella Papageorgiou Clinique Vétérinaire Advetia, Paris, France
  • Massimo Orioles Village Vet, Cambridge, United Kingdom

Published:

2017-02-28

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DOI

https://doi.org/10.18849/ve.v2i1.58

Abstract

Generalised epileptic seizures and syncope are two syndromes with similar clinical manifestation and their differentiation can be quite challenging. The aim of this review is to use an evidence-based approach in differentiating these two syndromes through the comprehension of the pathophysiological mechanisms involved and their clinical signs. Both syndromes affect regions of the forebrain and consciousness level, although, different mechanisms are involved. Syncope is a paroxysmal event secondary to a short-term decrease in cerebral perfusion, oxygenation or essential nutrients delivery. Generalised epileptic seizure activity is defined as the clinical manifestation of transient paroxysmal disturbances in brain function secondary to an imbalance between excitatory and inhibitory neurotransmitters. Clinical criteria, including precipitating events, clinical signs preceding, during and following the episodes and event duration, can be used to differentiate the two syndromes. Although these criteria might be useful for the practitioner, definite conclusions should be precluded due to the lack of original research articles and weak evidence on this specific field.

Application: The review might be a useful tool for the general practitioner and clinical scientist as it will aid towards the differentiation of two syndromes, i.e. generalised epileptic seizures and syncope, with similar clinical presentation.


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