Syncope differentials

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Definition: The transient loss of conciousness caused by transient global hypoperfusion of the brain. Syncope is sudden onset, occurs for a short duration, and is characterised by spontaneous complete recovery.

Causes and Differentials: 
Syncope presents as a transient loss of conciousness but is defined by its pathophysiology (transient global hypoperfusion) and is therefore different to other causes of loss of conciousness. Syncope can be divided into 3 main types which are summarised below: 
Reflex syncope is the most common type.  


Reflex syncope is the most common diagnosis, whilst cardiac syncope should be ruled out due to its dangerous nature. 



Other causes of transient loss of conciousness include: 

  • Trauma- usually easily identifiable due to history
  • Epilepsy- may present with tonic clonic movements or other abnormal movements
  • Metabolic causes - eg. hypoglycaemia, hypoxia, hypercapnia, and hypertension
  • Psychogenic syncope
  • loss of conciousness caused by transient ischaemic attacks (TIA) are very rare and only occur in vertebrobasilar TIAs.
  • Often the cause of loss of conciousness is unknown. 


 Many conditions which do not involve the transient loss of conciousness may also be confused with syncope. This includes conditions such as: 
  • cataplexy
  • drop attacks
  • Falls in the elderly
  • Carotid  TIAs

http://www.escardio.org/guidelines-surveys/esc-guidelines/implementation/Pages/syncope.aspx
http://www.patient.co.uk/doctor/syncope

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