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Seizures and fainting (syncope)
What is a seizure?
A seizure is a sudden, involuntary change in behavior, muscle control, consciousness, and/or sensation. A seizure is often accompanied by an abnormal electrical discharge in the brain. Symptoms of a seizure can range from sudden, violent shaking and total loss of consciousness to staring into space, altered vision, and difficult speech. Approximately 10 percent of the population will experience a single seizure in their lifetime. (Source: Epilepsy Foundation)
What is syncope or fainting?
Syncope (sing'-koe-pee), the medical term for fainting, is the sudden loss of consciousness and physical collapse due to lack of blood and oxygen to the brain. Syncope can occur with or without warning, as an isolated event, or frequently over time. Syncope is sometimes characterized by symptoms that mimic an epileptic seizure such as confusion muscle twitching, shaking, convulsions and physical collapse.
Is a seizure the same as syncope?
No, but it can be very difficult to distinguish between an epileptic seizure and syncope. Syncope may result in movements or behaviors that mimic seizures. The difference is, an epileptic seizure produces a brief disturbance in the normal electrical functions of the brain, while syncope is caused by a reduction in blood flow carrying oxygen to the brain. A seizure can sometimes accompany a syncope episode and syncope can sometimes accompany a seizure.
What causes syncope?
Syncope usually occurs when the brain does not receive enough blood and oxygen. Some causes of syncope are relatively harmless, and others can be life threatening. Cardiovascular causes of syncope can be among the most serious. One of the most common heart-related causes is an abnormal heart rhythm (also known as an arrhythmia). In these cases, the heart beats too slowly, rapidly, or irregularly to pump enough blood to key parts of the body, including the brain.
Other causes of syncope include some neurological disorders, psychological conditions, and obvious situations such as standing up too fast or being in a hot room. These factors contribute to making the cause of syncope difficult to diagnose.
How is syncope treated?
If syncope is caused by an abnormal heart rhythm, therapy options may include medication, an implantable device (such as a pacemaker or implantable cardioverter-defibrillator (ICD), or corrective surgery, such as catheter ablation.
With appropriate treatment, a person suffering from cardiovascular syncope can often resume normal activities without fear of having another episode. Treatment may eliminate the syncope and may also treat the potentially life-threatening cardiovascular cause, thereby improving a person's overall quality of life.
What causes seizures or seizure-like episodes?
Although the cause cannot always be identified, there are many different conditions that can cause seizures or seizure-like episodes. These can be grouped into four categories: neurological, psychological, cardiovascular, and other causes.
- Neurological conditions stemming from infections, brain injury, tumors, stroke, etc. These most often lead to changes in brain electrical activity and are sometimes referred to as "epileptic seizures."
- Cardiovascular conditions due to heart rhythm abnormalities, blocked vessels, blood pressure irregularities, etc. These can lead to symptoms that are almost identical to seizures from neurological conditions.
- Psychological conditions including panic attacks, hysteria, emotional distress, etc. Seizures caused by psychological conditions are often referred to as psychoseizures, pseudoseizures, or non-epileptic seizures.
- Other causes can be related to metabolism (electrolyte imbalance, low blood sugar), diabetes, a high fever, etc.
What is the most efficient way to determine the cause of seizure-like episodes?
Correctly evaluating the cause of recurrent seizures or seizure-like episodes requires the collaboration of several medical specialists beyond the general practitioner, internist, or pediatrician. These specialists may include a neurologist or epileptologist if a neurological cause is suspected. If a cardiovascular cause for seizure-like episodes is suspected, a cardiologist or an electrophysiologist (a cardiologist with special training in diagnosing and treating abnormal heart rhythms) should be consulted. If a psychological cause is suspected, psychiatric evaluation may be required.
What is the risk of having a seizure?
According to the Epilepsy Foundation, approximately 10 percent of the U.S. population will experience seizure-like symptoms in their lifetime. That is, about twenty-five million Americans (one in every ten) have had, or will have, a seizure at some point in their lives.
In the United States, the Epilepsy Foundation estimates that approximately $1.7 billion is spent in direct costs on patients with epilepsy and seizures.
What is the risk of having syncope?
Thirty percent of the U.S. population will faint during their lifetime, at a cost of more than $1 billion annually. (Source: HCIA, Inc., October, 1996-September, 1997)