Syncope And Paroxysmal Conditions In Neurology And Cardiology

Abstract

Paroxysmal disorders and conditions such as syncope in particular are a controversial matter in neurology, cardiology, psychiatry and other medical fields. The clinical presentation is often unclear and misleading which hinders the final diagnosis and the discovery of an etiological cause. Aim: To present different forms of paroxysmal syncopal states and compare their evaluation, differential diagnosis and therapy. We have successively reviewed the most common neurological and cardiovascular factors for syncope. Special emphasis is placed on the relationship and differentiation between syncope, epileptic seizures and epilepsy; reflex-mediated syncopes; basilar migraine syncope; syncope due to autonomic nervous system dysfunction, orthostatic hypotension; stealth syndrome of the subclavian artery; transient ischemic attacks and psychogenic attacks that mimic syncopal conditions. We defined the most crucial questions concerning the patient history, laboratory tests and instrumental examinations to aid the diagnosis of syncopal conditions. An adequate diagnostic and therapeutic behavior are proposed for the different clinical groups. Summary: Neurology, cardiology and other medical specialties comprise various conditions that present clinically as paroxysmal. Although they are the result of different etiologic and pathological causes, their clinical manifestation is very similar and their diagnostics and treatment require greater qualification from the specialist. That is why the key moment in successfully dealing with these patients is to get a thorough patient history and work in a cohesive interdisciplinary team of neurologists, cardiologists and other clinicians as well as implementing new methods and strategies for clinical evaluation, differentiation and therapeutic behavior.