Transient loss of consciousness: Neurally-mediated syncope, psychogenic syncope or epilepsy? A cross-sectional study


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Kayılıoğlu H., Yayıcı Köken Ö.

Northwestern Medical Journal, cilt.3, sa.3, ss.123-129, 2023 (Hakemli Dergi)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 3 Sayı: 3
  • Basım Tarihi: 2023
  • Doi Numarası: 10.54307/nwmj.2023.70288
  • Dergi Adı: Northwestern Medical Journal
  • Derginin Tarandığı İndeksler: TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.123-129
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Aim: This study aimed to define important clinical and laboratory features that may be useful in the differential diagnosis of pediatric patients who presented with temporary loss of consciousness and in whom cardiac causes had been excluded, especially in the differentiation of convulsive syncope and epileptic seizure. Methods: The records of patients presenting with temporary loss of consciousness and in whom cardiac causes had been excluded, were retrospectively evaluated. All patients were grouped according to their diagnosis and the data were evaluated comparatively. Results: Six-hundred-and-twelve patient files were evaluated, and 350 patient files were included in the study. 68.6% of the patients were diagnosed with vasovagal syncope, 13.1% were diagnosed with psychogenic pseudosyncope and 18.2% of the patients were diagnosed with epilepsy. In addition, compared to other subgroups, the patients in the epilepsy group were younger (p<0.001), the total number of attacks was lower (p<0.001), the attacks lasted longer (p<0.001), post-attack symptoms were more common (p<0.001), and urinary incontinence and motor movements were more frequent (p<0.001). Conclusion: The incidence of epilepsy was found to be significantly higher than expected in the pediatric patients presenting with transient loss of consciousness without cardiac reasons. Patient age, number and duration of attacks, presence of urinary incontinence and motor movements may also be important in the differential diagnosis of transient loss of consciousness. This study indicates that the management of transient loss of consciousness needs to be tailored to pediatric patients