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October 1990

Is Electroencephalography Necessary in the Evaluation of Syncope?

Author Affiliations

Department of Neurology University of Mississippi Medical Center 2500 N State St Jackson, MS 39216

Arch Intern Med. 1990;150(10):2007-2008. doi:10.1001/archinte.1990.00390210009002

Syncope is the sudden and reversible loss of consciousness (LOC); it is usually precipitated by a transient and diffuse cerebral ischemia or anoxia.1 Accompanying the LOC is the progressive loss of muscle tone leading to a gradual collapse in the posture. If the duration of cerebral ischemia is prolonged, syncope may be attended by brief myoclonic jerks, followed by tonic extensor posturing resembling decerebrate rigidity.2 Although the attack occurs paroxysmally, syncope is not considered an epileptic disorder. On the contrary, the LOC in syncope is related to a temporary "paralysis," or loss of cerebral function, as a consequence of the global anoxia, and not, as in the case of an epileptic seizure, due to an abnormally excitable and discharging cerebral cortex. Since both epilepsy and syncope are relatively common conditions and each can produce a temporary impairment in consciousness, differentiating between a "faint" and a "fit" as the

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