Syncope + NEAD

Question 1

What is Syncope?

Answer 1

Fainting, most common cause of TLOC.

Caused by decreased blood flow to brain.

Question 2

Common signs of all Syncope?

Answer 2

Quick onset, <2min duration + rapid recovery.

Question 3

What is Vasovagal syncope + signs?

Answer 3

Baroreceptors cause vasodilation = bradycardia

Pre-syncopal symptoms (nausea, pallor, sweating).

Question 4

What is Cardiogenic Syncope?

Answer 4

Decreased blood flow due symptoms of CV disease

No pre-syncopal symptoms/warning - ‘On/off’ onset

Question 5

Common Subtypes of VV + CG syncope?

Answer 5

V: Carotid sinus syncope
C: Stoke Adams Attacks (can be several times per day)

Question 6

Investigations for Syncope?

Answer 6

1) 24h ECG
2) Bloods - differentiation of cause
3) Imaging (depends on cause) e.g. CV = echo
4) CT/MRI or EEG = supportive evidence

Question 7

Management of Syncope?

Answer 7

Treat the underlying Cause.

Question 8

What is NEAD?

Answer 8

Non-epileptic Attack Disorder, psychogenic seizures.

Question 9

Common Presentation of NEAD?

Answer 9

Partially conscious and/or responsive to stimuli
Longer duration (up to >30 min)

Question 10

Investigations for NEAD?

Answer 10

Video Footage of Seizure = 1st line diagnostic tool

Tests - Obs, ECG, EEG: ALL NORMAL!

Question 11

Management of NEAD?

Answer 11

Psychotherapy e.g. CBT