Epilepsy Talk

Syncope or Seizure? | May 16, 2018

Studies have now confirmed what some doctors have long suspected — many young people who are given the diagnosis of epilepsy (or seizure disorder) apparently don’t have epilepsy at all.

Instead, they have a condition known as syncope.

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. It can occur with or without warning — as an isolated event — or frequently, over time.

Since syncope can mimic the symptoms of some epileptic seizures — such as muscle twitching, shaking, convulsions and physical collapse — the confusion begins.

And that confusion can lead to misconceptions, misperceptions and a wrong diagnosis with ineffective medications given.

For example: What if you were given anti-seizure medication for syncope and developed irreversible heart disease? Or vice versa. You could be given cardiac drugs for epileptic seizures and there would be no relief.

Even worse, at least some of the arrhythmias (abnormal heart rhythms) that cause syncope, but are misdiagnosed as epilepsy, can become fatal if they are not recognized and treated appropriately.

What’s the difference? What’s syncope and what’s a seizure?

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.

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 even more difficult to diagnose.

To make it even more confusing, a seizure can sometimes accompany a syncope episode and syncope can sometimes accompany a seizure!

Syncope is not caused by head trauma, since loss of consciousness after a head injury is considered a concussion.

However, syncope fainting can cause injury if the person falls and hurts themselves.

The person is unaware that they’ve passed out and fallen to the ground. Although they may hurt themselves in the process, it’s only afterward that they understand what has happened.

There may be symptoms or signs before the syncopal episode, (like auras) which may include:

Feeling muscle twitching, shaking, convulsions and physical collapse…a feeling of dizziness or vertigo (with the room spinning). Vision may fade or blur, and there may be muffled hearing and tingling sensations in the body.

During the episode, when the person is unconscious, there may a few twitches of the body which can again be confused with seizure activity.

Usually the loss of consciousness is not long. Once a person falls to the ground and the blood rushes to their brain, they rapidly regain consciousness.

After the episode, they come around rapidly and know where they are and not confused or disoriented.

Are you confused yet? Well to help understand the difference between the two, here’s a brief description of some likenesses and differences between syncope and seizures…

Warnings
Seizures: Usually an aura involving sensory symptoms.
Syncope: Faint feeling, light-headed, blurred/darkened vision.

Onset
Seizure: Sudden, any position.
Syncope: Only occurs sitting or standing — avoidable by change in posture.

Features
Seizures: eyes open, rigidity, falls backwards, convulses.
Syncope: Only occurs standing or sitting, eyes closed, limp, falls forward, minor twitching, (if unable to fall flat).

Recovery
Seizures: Confusion, headache, sleepy, focal deficit.
Syncope: Pale, washed out, sweating, cold and clammy.

Other features
Seizures: Tongue bite, loss of bladder control common.
Syncope: Loss of bladder control rare.

And, as you may say, there are differences in the numbers, too.

According to the Epilepsy Foundation, approximately 10 percent of the U.S. population will experience seizure-like symptoms in their lifetime.

That’s 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.

With syncope, thirty percent of the U.S. population will faint during their lifetime, at a cost of more than $1 billion annually.

Yet anyway you look at it, there are important distinctions to be made. Diagnostic decisions, medications prescribed, and environment. All of which impacts upon the quality of lifestyle.

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Resources:
http://wwwp.medtronic.com/Newsroom/LinkedItemDetails.do?itemId=1160041417054&itemType=fact_sheet&lang=en_IN
http://circ.ahajournals.org/content/113/16/e715.full
http://www.medicinenet.com/fainting/article.htm
http://heartdisease.about.com/cs/generallinks/a/syncopeseizure.htm
https://braindiseases.wordpress.com/2009/04/13/is-it-a-seizure-or-is-it-syncope-the-story-continues/
https://mmcneuro.wordpress.com/2013/06/19/blackout-was-a-fit-or-a-faint/
http://www.medsci.org/v06p0296.htm


18 Comments »

  1. Thank you for distinguishing these conditions. Some people cannot tell, and either don’t respond or respond with too much fervor to syncope. Great article!

    Liked by 1 person

    Comment by megambon2164 — May 16, 2018 @ 9:54 AM

  2. thank you for distingsh this there are my friends that dont understand what i have to put up with and thay think i am just makeing it up

    Liked by 1 person

    Comment by pooterbear — May 16, 2018 @ 12:08 PM

  3. It is so difficult sometimes, as you know. Some are willing to listen, others are willing to understand. But when someone actually sees a seizure, they are terrified, even of a complex partial. Hence the “embarrassment to the office” comment that still stings yet motivates me. Who is the embarrassment now?

    Liked by 1 person

    Comment by megambon2164 — May 16, 2018 @ 12:36 PM

  4. Well said.

    Liked by 1 person

    Comment by megambon2164 — May 16, 2018 @ 12:45 PM

  5. This is all interesting to see just how quickly all neurologists says a person young or old has epilepsy. Wonder if all the AED’s & the many one can take all has everything to do with a diagnosis of Epilepsy ? So when one takes too much tegretol that can make th heart act crazy & cause seizures, guess now maybe that is a syncope condition & no real seizures happening. Also will the diagnosis of a SINUS condition, that can make SINUS SEIZURES happen, maybe is not Epilepsy either. Never been DX with that condition, as I know at times maybe 1/2 of my days & nights, there is some trouble breathing good through my nose, especially the Right side. Most of my problems with my seizure condition is on the RIGHT side. Now is that a coincidence or what ? Still the food chemical industry can make any brain act to excited & never allow human brains to relax, so seizures are the results.

    Liked by 2 people

    Comment by C D — May 16, 2018 @ 1:22 PM

  6. I wonder if that’s why I have such bad sinus problems, especially on one side!

    Liked by 1 person

    Comment by megambon2164 — May 16, 2018 @ 1:31 PM

  7. The whole thing is a revelation to me!

    Like

    Comment by Phylis Feiner Johnson — May 16, 2018 @ 1:53 PM

    • CD,
      Thank you for your reference to the “Sinus Siezures”.
      While I doubt your designation of “SINUS SIEZURE” is any medically accepted norms to Epilepsy or have any relationship to commonly defined symptoms to seizures, surprisingly I can feel & tell my grand-mal siezures are going to strike soon, by the very sharp sinuses I feel on the right side of my nostril, as if I’m coming up with cold or flu related symptoms & sinuses.
      So far, I considered the “sinuses” as part of the Auras I learned to accept as part of my Epileptic seizures.
      Let’s hope, Neurological studies will someday come up with better explanation to the relationships between sinuses & siezures.
      Again, thank you for pointing out into very little known symptom of Epileptic seizures.

      Gerrie

      Liked by 1 person

      Comment by BahreNegash Eritrea — May 16, 2018 @ 11:31 PM

      • Another lesson learned.

        “An epilepsy seizure can follow a frontal sinusitis. It does not convey the existence of an endocranial complication but requires researching it. The posterior wall lysis of the sinus with a bare dura mater is sufficient to lead to a seizure in case of sinus infection.”

        https://www.ncbi.nlm.nih.gov/pubmed/17475201

        Like

        Comment by Phylis Feiner Johnson — May 17, 2018 @ 9:07 AM

  8. Thank you for this great info. My husband and daughter have syncope. I have some type of epilepsy but not too sure which one! I only have them when I’m under a lot of stress. I can go with years not having them at all. I’ve learned to let go what I have no control in life. So my health can stay good. What usually happens to me when I have this seizure, it’s just a blank stare. I don’t fall or have a convulsion of any kind. I’m just in a daze like I’m starring at a blank wall. My family can be calling my name and I don’t answer. When I do come out of it, I’m back to normal and into the conversation.

    Liked by 1 person

    Comment by Teresa Hansen — May 16, 2018 @ 3:00 PM

    • It’s good to let go of your stress. That’s the number one trigger for seizures.

      But, it sounds to me like you may be having Absence Seizures.

      Absence seizures or “Petit Mals” account for 2-4 percent of epilepsy.

      They are characterized by brief episodes of staring, usually lasting only 2-10 seconds and may happen repeatedly during the day.

      There is no warning before a seizure and the person is completely alert afterwards, with no memory of it.

      Because they are so mild, you might not even realize you had one and it’s easily not noticed by those around you.

      Liked by 1 person

      Comment by Phylis Feiner Johnson — May 16, 2018 @ 3:15 PM

  9. I am 70, 5 years ago I got my first seizure during sleep, my dear wife organised for me to be ambulanced to hospital, yes you have just had a seizure and you have epilepsy I was told, ?????, they also picked up that I had a heart rate in the thirties so a pacemaker was installed, an interesting synergy here with the current newsletter, I am taking Levetiracetam 500 mg, 1 x am 2 x pm, have been more and less with quantities, makes no difference, seizures continue, only at night roughly monthly but did achieve 10 weeks once, we are constantly reviewing the previous 24 hours in terms of food/alcohol/etc and still on the case,

    Liked by 1 person

    Comment by Donald Nairn — May 16, 2018 @ 7:06 PM

    • Donald, it sounds to me like you have Nocturnal Seizures.

      According to an article in Journal of Neurology, Neurosurgery & Psychiatry, if more than 90 percent of your seizures occur while sleeping, you are said to have sleep seizures.

      The article also notes that an estimated 7.5 percent to 45 percent of people who have epilepsy have some form of sleep seizures.

      Since seizures occur in sleep during the night, it’s often hard to diagnose them, except for unusual movements at night, confusion upon awakening, bed wetting or falling out of bed.

      However, these symptoms are also a kind of parasomnia — an umbrella term for a group of sleep disorders that include night terrors, sleepwalking, teeth grinding, and restless leg syndrome.

      It’s believed that sleep seizures are triggered by changes in the electrical activity in your brain during the stages of sleeping and awakening.

      Most nocturnal seizures occur in stage 1 and stage 2, which are the stages of lighter sleep.

      And nocturnal awakenings are sometimes confused with insomnia.

      Epilepsy patients are often unaware of the seizures that occur while they sleep.

      They may suffer for years from daytime fatigue and concentration problems without ever knowing why.

      Liked by 1 person

      Comment by Phylis Feiner Johnson — May 16, 2018 @ 8:49 PM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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