Table 2.
Differential diagnosis of seizures and syncopes.
| SYNCOPE | SEIZURE | |
|---|---|---|
| TRIGGERS | Frequent | Rare |
| PRECEDING SYMPTOMS | Nausea, visual blurring, epigastric sensation, heat, headache, or tinnitus | Sensorial, psychic, somatosensory ‘auras’ ormotor phenomena |
| POSITION | Usually while standing or sitting. Supine very rare | Any |
| LOSS OF CONSCIOUSNESS | ‘Fading away’ in young patients or abrupt loss in elderly persons | Abrupt loss |
| FALL | Slow or flaccid | Fast or tonic |
| SKIN COLOR | Pale | Sometimes perilabial cyanosis |
| EYE DEVIATION | Transient upward or lateral deviation | Sustained lateral deviation |
| INCONTINENCE | Common | Common |
| TONGUE BITE | Uncommon; localization: on the tip of the tongue | Common; localization: on the side of the tongue |
| CONVULSIONS | Lasts a few seconds and is arrhythmic, multifocal, or generalized | May last a few minutes and is rhythmic and generalized |
| DURATION | 3–30 s | Depends on the type of seizure: up to 5 min for GTCS and shorter for others |
| POST-ICTAL PERIOD | Somnolence, fatigue, or headache | Confusion, somnolence, or headache |