Seizure vs Syncope

Determine which patients are likely to have seizure versus syncope as the cause of loss of consciousness

Questions

1.At times do you wake with a cut tongue after your spells?

2.At times do you have a sense of deja vu or jamais vu before your spells?

3.At times is emotional stress associated with losing consciousness?

4.Has anyone ever noted your head turning during a spell?

5.Has anyone ever noted that you are unresponsive, have unusual posturing OR have jerking limbs during your spells or have no memory of your spells afterwards?

6.Has anyone ever noted that you are confused after a spell?

7.Have you ever had lightheaded spells?

8.At times do you sweat before your spells?

9.Is prolonged sitting or standing associated with your spells?

About

Sheldon et al. (2002) derived this Seizure vs Syncope score to help practitioners differentiate between these two entities, which combined cause the majority of episodes of loss of consciousness. Using a population of 671 patients, 539 of which had a confirmed etiology (e.g. by electroencephalography, electrocardiography, and/or tilt-table testing), symptoms were analyzed and the nine questions in the score were determined to yield 94 % sensitivity and specificity when combined. A limitation of the study was the exclusion of patients with more than one diagnosis. As well, because EEG was done after the event and not during, patients with normal interictal EEGs could not be diagnosed with seizure.

References

Sheldon R, Rose S, Ritchie D, Connolly SJ, Koshman ML, Lee MA, Frenneaux M, Fisher M, Murphy W.

Historical criteria that distinguish syncope from seizures.

Journal of the American College of Cardiology 2002 July 3, 40 (1): 142-8

The Seizure vs Syncope calculator is created by QxMD.

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1. At times do you wake with a cut tongue after your spells?

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