|
SEIZURE |
SYNCOPE |
ONSET |
Sudden loss of consciousness
OR
Preceding Aura (may include):
Focal sensory phenomena
Focal
motor phenomena
Sensation of fear
Olfactory
hallucinations
Gustatory
hallucinations
Other emotional sensations |
Progressive
light-headedness
Dimming
of vision
Faintness
Nausea
Pallor
Diaphoresis |
DURING |
Loss of consciousness with tonic clonic movements
OR
Isolated motor findings
OR
Altered consciousness (awake but
unresponsiveness or poorly responsive to the environment) |
Usually flaccid
Loss of
consciousness
Unresponsiveness
but may have stiffening/jerking
movements, especially if hypoperfusion is prolonged |
LENGTH |
Typical seizure (actual ictal
period)
is 30 sec - 2 minutes |
Loss of consciousness
rarely more than 15 sec |
POSTURE |
Can occur in any position |
More common in upright position |
EXERTION |
Not related to exertion |
May be related to exertion |
AFTER |
Post-ictal
state
Confusion,
disorientation and/or agitation
May last 30 min to 2 hours; may last
longer in the elderly |
Full lucidity
with return of consciousness
usually immediately
(typically under 30 sec) |
OTHER |
All of the following favor
seizure:
Urinary
incontinence
Tongue biting
Multiple bruises on the extremities |
All of the following favor syncope:
History of
prior fainting to emotional stimuli (e.g., sight of blood)
Palpitations
History of cardiac disease
Bradycardia
Abnormal EKG |