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Managing psychogenic pseudosyncope: Facts and experiences.

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Psychogenic pseudosyncope (PPS), a common cause of apparent transient loss of consciousness, is often underdiagnosed. Early diagnosis and clear communication are crucial for improving patient outcomes and quality of life.

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Area of Science:

  • Neurology
  • Psychiatry
  • Cardiology

Background:

  • Psychogenic pseudosyncope (PPS) is a frequent cause of transient loss of consciousness (TLOC).
  • PPS significantly impacts patients' quality of life.
  • It is often underdiagnosed and misdiagnosed, similar to psychogenic nonepileptic seizures (PNES).

Purpose of the Study:

  • To provide a comprehensive overview of PPS.
  • To cover definition, incidence, etiology, diagnosis, treatment, and prognosis.
  • To synthesize literature data and clinical experience.

Main Methods:

  • Literature review and synthesis of personal experience.
  • Emphasis on detailed patient history.
  • Diagnostic confirmation using tilt-table testing with simultaneous BP, heart rate, and video-EEG monitoring.
  • Utilizing home video and BP recordings during events.

Main Results:

  • PPS is common but not widely recognized.
  • Frequent, prolonged episodes of apparent TLOC with closed eyes are key historical features.
  • Tilt-table testing with multimodal monitoring provides definitive diagnosis.
  • Effective communication of diagnosis is vital.

Conclusions:

  • A detailed history is paramount for diagnosing PPS.
  • Diagnostic certainty is achieved through objective monitoring during a typical event.
  • Cognitive behavioral therapy, as suggested by PNES literature, may be beneficial for treatment.