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How to avoid a misdiagnosis in patients presenting with transient loss of consciousness

Postgraduate Medical Journal, 2006-10, Vol.82 (972), p.630-641 [Peer Reviewed Journal]

Copyright 2006 The Fellowship of Postgraduate Medicine ;2006 INIST-CNRS ;Copyright: 2006 Copyright 2006 The Fellowship of Postgraduate Medicine ;Copyright ©2006 The Fellowship of Postgraduate Medicine. ;ISSN: 0032-5473 ;EISSN: 1469-0756 ;DOI: 10.1136/pgmj.2006.046565 ;PMID: 17068273

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Title:
How to avoid a misdiagnosis in patients presenting with transient loss of consciousness
Author: Petkar, Sanjiv ; Cooper, Paul ; Fitzpatrick, Adam P
Subjects: Automobile Driving - legislation & jurisprudence ; Biological and medical sciences ; blackouts ; Diagnostic Errors - prevention & control ; Diagnostic Imaging ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Driver Vehicle and Licensing Agency ; DVLA ; ECG ; EEG ; electrocardiography ; Electrocardiography - methods ; electroechocardiography ; epilepsy ; Epilepsy - complications ; General aspects ; Hospitalization ; Humans ; ILR ; implantable loop recorder ; magnetic resonance imaging ; Medical sciences ; misdiagnosis ; MRI ; NEAD ; Nervous system (semeiology, syndromes) ; Neurology ; non-epileptic attack disorder ; Prognosis ; psychogenic blackouts ; Review ; Secondary Prevention ; SHD ; structural heart disease ; sudden unexpected death in epilepsy ; SUDEP ; syncope ; Syncope - complications ; T-LOC ; Tilt-Table Test ; transient loss of consciousness ; Unconsciousness - etiology
Is Part Of: Postgraduate Medical Journal, 2006-10, Vol.82 (972), p.630-641
Description: Daily in the UK, frontline medical and paramedical staff are required to manage patients with “collapse ?cause”. This universal colloquialism refers to patients who have had an abrupt loss of postural tone. Some of these patients would have had a “blackout” or a transient loss of consciousness (T-LOC). The three most important causes of T-LOC are syncope, epilepsy and psychogenic blackouts. Determining the correct cause is an important challenge; if the initial clinical diagnosis is wrong, investigations may be misdirected, and the final diagnosis and treatment incorrect. Syncope is much more common than epilepsy and may present with symptoms akin to the latter. This fact is not well appreciated and often leads to misdiagnosis. This article deals with the clinical features of the three main causes of blackouts, the value of investigations in arriving at a diagnosis and the problem of misdiagnosis. Pathways for managing patients presenting with blackouts are suggested.
Publisher: London: The Fellowship of Postgraduate Medicine
Language: English
Identifier: ISSN: 0032-5473
EISSN: 1469-0756
DOI: 10.1136/pgmj.2006.046565
PMID: 17068273
Source: Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
PubMed Central
Alma/SFX Local Collection
ProQuest Central

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How to avoid a misdiagnosis in patients presenting with transient loss of consciousness

Copyright 2006 The Fellowship of Postgraduate Medicine ;2006 INIST-CNRS ;Copyright: 2006 Copyright 2006 The Fellowship of Postgraduate Medicine ;Copyright ©2006 The Fellowship of Postgraduate Medicine. ;ISSN: 0032-5473 ;EISSN: 1469-0756 ;DOI: 10.1136/pgmj.2006.046565 ;PMID: 17068273

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