![]() ![]() A century later, Dell and colleagues demonstrated that motor activation in the early stages of cerebral hypoxia resulted from the combined effects of direct hypoxic activation of the brainstem reticular formation and cortical suppression with subsequent reticular disinhibition ( 11). The term “convulsive syncope” specifies a common variant of syncope that is accompanied by tonic or myoclonic activity.Īnimal experiments on convulsive syncope date back to the middle of the 19th century, when Kussmaul and Tenner showed that anoxic convulsions occur after ablation of the telencephalon but not after destruction of the brainstem ( 11). Syncope is defined as a brief loss of consciousness and upright posture due to global cerebral hypoxia. Specific provocation and rapid reorientation help to distinguish syncope from generalized tonic clonic seizures.Myoclonus is usually brief, arrhythmic, and multifocal.Syncope is often accompanied by tonic or myoclonic muscle activity. ![]() An increasingly recognized and treatable cause of syncope is ictal asystole or bradycardia during temporal lobe seizures. Investigations such as tilt testing or creatine kinase levels may be helpful but are never diagnostic in isolation. Recognition of syncope also depends on accurate information about premonitory symptoms and postictal events. Differential diagnosis is based on the specific features and not the mere presence or absence of these phenomena. Syncope is commonly accompanied by tonic or myoclonic muscle activity, eye deviations, automatisms, vocalizations, and hallucinations, which may all complicate the distinction from epileptic seizures. In this article, the author provides an overview of convulsive syncope. ![]()
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