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Syncope causes transient focal neurological symptoms.
D J Ryan1, J A Harbison2, J F Meaney3
1From the Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland and d_jamesryan@yahoo.co.uk.
QJM : Monthly Journal of the Association of Physicians
|January 30, 2015
Summary
Focal neurology (FN) affects approximately 5.7% of syncope patients, often linked to vasovagal syncope. This neurological condition typically resolves within 24 hours and does not lead to long-term deficits.
Area of Science:
- Neurology
- Cardiology
- Internal Medicine
Background:
- Focal neurology (FN) occurring during syncope is not well understood.
- Determining the prevalence and risk factors of FN in syncope patients is crucial for accurate diagnosis and management.
Purpose of the Study:
- To investigate the prevalence of focal neurology (FN) in patients presenting with syncope or pre-syncope.
- To identify risk factors associated with FN in this population.
- To assess the short-term consequences of FN.
Main Methods:
- A consecutive sample of 540 syncope-unit attendees underwent detailed syncope evaluation and assessment for FN using questionnaires, interviews, and MRI.
- Risk factors for FN were analyzed by comparing cases with syncope controls.
- Participants were followed for 24 months.
Main Results:
- FN occurred in 5.7% of patients (31/540), predominantly associated with vasovagal syncope (71%).
- Identified risk factors for FN included frequent syncope, childhood syncope, and delayed diastolic recovery.
- No recurrence of FN was observed during the 24-month follow-up, and MRI revealed no new neurological deficits.
Conclusions:
- Focal neurology co-exists in approximately 1 in 20 syncope patients and does not result in persistent deficits beyond 24 hours.
- Recognizing the co-occurrence of FN and syncope is vital to prevent misdiagnosis as stroke and subsequent inappropriate aggressive management.
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