Full Text (PDF)
Case Report

Loss of Conciouness is not always Neurological Aetiology, Must not Forget Cardiogenic Event: A Single Case Study

Satender Tanwar, Mayank Chugh

Author Information

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


RFP Gastroenterology International 8(1):p 23-25, January-June 2023. | DOI: 10.21088/gi.2456-5458.8123.3

How Cite This Article:

Chugh M, Tanwar S. Loss of consciousness is not always neurological aetiology, must not forget cardiogenic event: a single case study. Gastroenterol Int. 2023;8(1):23–5.

Timeline

Received : February 20, 2023         Accepted : May 03, 2023          Published : June 15, 2023

Abstract

Medical education relies upon the through clinical examination and history taking in exact and proper diagnosis of the patient.1 The patient who has the symptoms which has the presentation of the multiple system sharing the same presentation need2 judicious examination and through evaluation. Similarly the article case study selected here is the syncope2 vs Siezure where both have the common feature such as the LOC– Loss of consciousness need the through evaluation for the same.3 Differentiating between syncope and seizures, a relatively easy task, is not quite so simple in the ED.4 Transient loss of consciousness can occur from seizure or syncope, and the emergency clinician must distinguish between the two general5 conditions, especially if it's the patient's first episode, and direct the appropriate initial evaluation and follow-up.6 Ten percent of patients diagnosed as having a seizure do not have a seizure disorder but rather a cardiovascular event that caused transient loss of consciousness.7 Basic ED labs and an ECG, even an out patient EEG, are not always sensitive enough to differentiate seizures8 from syncope. Long-term ECG monitoring, as well as tilt table testing, are some tools that can further reveal the origin of the transient loss of consciousness.


References

  • 1.   Seltzer S, McCabe BF. Perilymph fistula: the Iowa experience. Laryngoscope. 1986;96(1):37–49.
  • 2.   Minor LB, Solomon D, Zinreich JS, et al. Sound-and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg. 1998;124(3):249–58.
  • 3.   Carey JP, Minor LB, Nager GT. Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Arch Otolaryngol Head Neck Surg. 2000;126(2):137–47.
  • 4.   Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders. 2nd ed. Oxford: Blackwell Publishing; 2003. p. 24–36.
  • 5.   Neuhauser HK, Leopold M, von Brevern M, et al. The interrelations of migraine, vertigo, and migrainous vertigo. Neurology. 2001;56(4):436–41.
  • 6.   Neuhauser HK, Lempert T. Diagnostic criteria for migrainous vertigo. Acta Otolaryngol. 2005;125(3):276–9.
  • 7.   Kim HY, Chung CS, Moon SY, et al. Complete nonvisualization of basilar artery on MR angiography in patients with vertebrobasilar ischemic stroke: favorable outcome factors. Cerebrovasc Dis. 2004;18(4):269–76.
  • 8.   Grad A, Baloh RW. Vertigo of vascular origin. Clinical and electronystagmographic features in 84 cases. Arch Neurol. 1989;46(3):281–4.
  • 9.   Colman N, Nali K, Ganzeboom KS, Shen WK, Reitsma J, Linzer M, et al. Epidemiology of reflex syncope. Clin Auton Res. 2004;14 Suppl 1:i9–i17.
  • 10.   Goldstein DS, Sharabi Y. Neurogenic orthostatic hypotension: a pathophysiological approach. Circulation. 2009;119(1):139–46.
  • 11.   Healey J, Connolly SJ, Morillo CA. The management of patients with carotid sinus syndrome: is pacing the answer? Clin Auton Res. 2004;14 Suppl 1:80–6.
  • 12.   Kapoor WN. Current evaluation and management of syncope. Circulation. 2002;106(13):1606–9.
  • 13.   Lewis DA, Dhala A. Syncope in pediatric patient. Pediatr Clin North Am. 1999;46(2):205–19.
  • 14.   Lewis T. A lecture on vasovagal syncope and the carotid sinus mechanism. Br Med J. 1932;1(3723):873–6.
  • 15.   Lipsitz LA, Wei JY, Rowe JW. Syncope in an elderly institutionalized population: incidence, prevalence and associated risk. Q J Med. 1985;55(217):45–54.
  • 16.   Luciano GL, Brennan MJ, Rothbberg MB. Postprandial hypotension. Am J Med. 2010;123(1):e1–e6.
  • 17.   Medow MS, Stewart JM, Sanyal S, Mumtaz A, Sica D, Frishman WH. Pathophysiology, diagnosis and treatment of orthostatic hypotension and vasovagal syncope. Cardiol Rev. 2008;16(1):4–20.
  • 18.   Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, et al. Guidelines for the diagnosis and management of syncope. Eur Heart J. 2009;30(21):2631–71.
  • 19.   Numerosos F, Mossini G, Lippi G, Cervellin G. Evaluation of the current prognostic role of cardiogenic syncope. Intern Emerg Med. 2013;8(1):69–73.
  • 20.   Osiro S, Zurada A, Gielecki J, Shoja MM, Tubbs RS, Loukas M. A review of subclavian steal syndrome with clinical correlation. Med Sci Monit. 2012;18(5):RA57–RA63.
  • 21.   Potter BJ, Pinto DS. Subclavian steal syndrome. Circulation. 2014;129(20):2320–3.
  • 22.   Raj SR, Coffin ST. Medical therapy and physical maneuvers in the treatment of the vasovagal syncope and orthostatic hypotension. Prog Cardiovasc Dis. 2013;55(5):425–33.
  • 23.   Rosanio S, Schwarz ER, Ware DL, Vitarelli A. Syncope in adults: systematic review and proposal of a diagnostic and therapeutic algorithm. Int J Cardiol. 2013;162(3):149–57.

Data Sharing Statement

There are no additional data available.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to all those who have contributed to this study.

Conflicts of Interest

The authors report no conflicts of interest in this work.


About this article


Cite this article

Chugh M, Tanwar S. Loss of consciousness is not always neurological aetiology, must not forget cardiogenic event: a single case study. Gastroenterol Int. 2023;8(1):23–5.


Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Received Accepted Published
February 20, 2023 May 03, 2023 June 15, 2023

DOI: 10.21088/gi.2456-5458.8123.3

Keywords

CardiogenicECGEEGHolterLOCSiezuresyncopeSyncope

Article Level Metrics

Last Updated

Monday 26 January 2026, 20:22:52 (IST)


571

Accesses

9
29
00

Citations


NA
NA
NA

Download citation


Article Keywords


Keyword Highlighting

Highlight selected keywords in the article text.


Timeline


Received February 20, 2023
Accepted May 03, 2023
Published June 15, 2023

licence


Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Access this article



Share