Definition and epidemiology
Convulsive syncope is a form of syncope which is accompanied by myoclonic jerks and tonic stretching. It must be differentiated from epileptic seizures.
Decreased CBF for more than 10 seconds causes these jerks.
- Vasovagal syncope
- Cardiogenic syncope
- Myocardial infarction
- Pulmonary embolism
- Antihypertensive drugs
Unlike epileptic seizures, convulsive syncope has the following clinical features:
- Usually brief (< 20 seconds)
- No post-convulsive confusion, the patient recovers immediately
- Tongue bite absent or on the apex of the tongue (not on the lateral side as in epileptic)
- Never starts with tonic phase
- Always starts with a clonic phase
- Eyes remain open
Diagnosis and evaluation
The patient should be evaluated for the underlying cause of the syncope.
4A. Myasthenia gravis