[Evaluation of syncope in medicolegal expertise]

The authors summarise the clinical characteristics of the syncope and neurological signs respectively caused by basilar vertebral artery insufficiency as well as carotid sinus hypersensitivity. Several authors have seen an increased number of patients with neurological symptoms caused by ischaemia in the region of the basilar artery occurring while driving and causing a traffic accident. Carotid sinus hypersensitivity as cause of driving accidents has much less importance. In the case of the authors on a 51 years old man after turning his head to the right a sudden transient loss of consciousness without signs of convulsion developed while driving a car. The attack resulted in a serious traffic accident. Vertebrobasilar insufficiency was presumed as the cause of the signs. Despite the rare incidence of isolated syncope caused by ischaemia in the region of basilar artery, after observation of one and half a year, chiefly supported by the pathological otoneurological findings, the definitive diagnosis could be established. The recurrence of the syncope could not be excluded. An inability to drive was established. The new hungarian legal regulation of 1992, of driving ability emphasises the extraordinary hazards in the traffic posed by processes the sinus of which occur associated with sudden loss of consciousness with great probability, perhaps rarely, but at any time.