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BRUCE ROSEMAN, M.D.
Syncope, defined as a transient loss of consciousness accompanied by loss of postural tone, is common and is a possible diagnosis in this case.4 Of the approximately 7800 men and women in the Framingham Heart Study,5 11 percent had reported a syncopal episode. Syncope accounts for 1 to 3 percent of visits to emergency departments and as much as 6 percent of hospital admissions.1,6
All forms of syncope result from a sudden decrease in cerebral blood flow — a low-flow state.7 A 35 percent reduction in cerebral blood flow, or a complete disruption of cerebral perfusion for 5 to 20 seconds, will result in depletion of the brain's oxygen stores and lead to syncope.8,9 In syncope, the resumption of cerebral blood flow is rapid; no neurologic sequelae occur.
(myoclonic jerks) may accompany cardiogenic syncope in approximately 20 percent of patients and frequently result in a misdiagnosis of seizure
Loss of consciousness precipitated by pain, exercise, micturition, defecation, or stress is probably due to syncope. Sweating and nausea before and during loss of consciousness are also more likely to occur with syncope than with seizure.