Can you have an unconscious seizure?
These symptoms are warning signs
MUNICH. The incorrect classification of syncope as an epileptic seizure is certainly much more common than the reverse incorrect classification, believes Professor Thomas Lempert from Berlin.
At the Neurowoche in Munich, he used examinations with medical students to show how the impotence initiated even with hyperventilation and pressure looks realistic clinically:
Most of the test subjects showed twitching, some of them were more pronounced and even bilaterally symmetrical myoclonia - actually a sign of a grand mal seizure.
Most students had their eyes open and rolled up during the fainting like a seizure event.
Vocalizations and hallucinations occurred in 40 and 60 percent of the subjects and were therefore also not uncommon.
The little differences
However, EEG findings with rhythmic electrical discharges, as in the case of a seizure event, were never seen in the healthy test persons. They were also quickly responsive, while patients often need 10 to 20 minutes to reorient after a grand mal seizure.
"That is the most important differential diagnostic criterion," emphasized Lempert. A trigger, if there is one, also indicates syncope.
Erecting up quickly or - not infrequently in older people - meals rich in carbohydrates can trigger orthostatic syncope.
Syncope during medical procedures, long periods of standing, aversive psychological stimuli, or micturition indicate a vasovagal cause.
Coughing and exertion can trigger syncope due to the resulting pressure, but exertion-related syncope can also have a cardiological cause.
According to Lempert, this should be borne in mind if the patient has a heart disease, the EKG is pathological, syncope occurs in old age without a clear trigger and syncope is reported while sitting or lying down as well as during physical exertion.
Because of the associated increased mortality, such cardiogenic syncope should always be investigated. (fk)
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