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.