Differential Diagnosis

Seizure disorders are frequently listed as a cause of syncope, and although they often cause a brief loss of consciousness, they do not share the same pathophysiologic mechanisms as syncope. Seizure is the most common event mistaken as syncope. History is very important in differentiating seizure from syncope. 16 Brief tonic movements of extremities may accompany syncope but do not represent true seizure activity. Urinary incontinence, which is often seen with seizures, may also occur with syncope. The most reliable differentiating factor is the postictal confusion period, which is commonly seen after a generalized seizure but is rarely associated with syncope. However, syncope itself may trigger a seizure, so that a seizure presentation does not exclude a syncopal origin.

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