Loss of consciousness

Different causes of collapse

 Neurology  Cardiology

SyncopeSeizureHypoperfusion
historySudden loss of consciousness usually with rapid recovery. May give history of palpitations.Tongue-biting, urinary incontinence, witnessed tonic-clonic movements.Feeling unwell prior to episode. Pallor, sweating.
examinationAbnormalities of the pulse. Look for aortic stenosis.May have focal neurological signs.Hypotension, dehydration, signs of sepsis. Drop in BP on standing.
investigationsECG, Tilt table testing, ECHO.EEG, brain imaging.
Important causesVentricular arrhythmias, aortic stenosis, massive pulmonary embolism.Stroke, new diagnosis of epilepsy, cerebral tumour / abscess.Sepsis, hypovolaemia, orthostatic hypotension.
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Cerebral lobe signs | Eponymous cardiac murmurs | Chest pain | Cranial nerves (ocular and smell) | Brain stem strokes | Valvular heart disease | Motor defects | Endocarditis | Hypertensive retinopathy | Cranial nerves (V, VII, VIII) |