4B. Convulsive syncope

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.

Etiology

  • Vasovagal syncope
  • Cardiogenic syncope
    • Arrhythmia
    • Myocardial infarction
    • Pulmonary embolism
  • Hypoglycaemia
  • Antihypertensive drugs

Clinical features

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.


Previous page:
4A. Myasthenia gravis

Next page:
5A. Polyneuropathies

Leave a Reply

Your email address will not be published.