Syncope

00:01 Syncope.

00:03 By definition, syncope is transient loss of consciousness and postural tone resulting from global cerebral hypoperfusion.

00:12 Global, cerebral, hypoperfusion.

00:17 Pre-syncope: Frequent sensation of lightheadedness and visual disturbance preceding syncope.

00:24 So instead of having that global hypoperfusion in which the patient may have almost like a faint-like episode, here we have frequent sensations of this.

00:35 We have headache, cognitive slowing, and buckling of the knees.

00:39 Syncope is most commonly a manifestation, most commonly a manifestation, of cardiovascular insufficiency and not necessarily neurologic, which in its own right, can be extremely dangerous.

00:54 The clinical pearls for syncope are the following: Syncope, as we just discussed, is not primarily a neurologic issue.

01:02 It is mostly a cardiovascular insufficiency.

01:05 For example, aortic stenosis.

01:08 Loss of consciousness, LOC, with syncope typically resolves immediately upon attaining a recumbent position, but may reoccur or be prolonged if patient is maintained upright.

01:23 Be careful with that.

01:24 Know the positional changes.

01:26 Convulsive syncope, what does this mean? Patients with syncope can have a few brief clonic jerks at the time they lose consciousness and this does not indicate however epilepsy or an increased risk of seizures.

01:40 Remember that with epilepsy or seizures, you can have the neurologic issues that we’ve talked about in greater detail, including our focal partial and then our generalized.

01:51 But that will be problem in the brain itself.

01:54 Here, if it’s cardiovascular, such as syncope, which is mostly what it is caused by, then during the periods of syncope, the patient seems as though that he or she might be having seizures, we call this convulsive syncope.