Convulsive syncope

Abstract

Myoclonic jerks seen during an episode of transient loss of consciousness often arouse concerns that the patient may be having epileptic seizures. Myoclonus, however, is not specific to epilepsy and frequently occurs in normal people who experience vasovagal syncope. Convulsive movement appear as the result of a reduction in global cerebral and brainstem perfusion due to transient systemic arterial hypotension. In distinguishing syncope from seizures, the most important diagnostic test is a ensuring a careful clinical history is acquired. When the diagnosis is uncertain, further evaluation with head-up tilt-table testing combined with EEG, and in some cases prolonged EEG or video-EEG may clarify the diagnosis and guide appropriate treatment.