Neurology, difference between epilepsy and syncope

Neurology, difference between epilepsy and syncope

The seizure is caused by the sudden, excessive and rapid discharge of a more or less extensive population of neurons that are part of the gray matter of the brain.

The set of neurons affected by the discharge is called the “epileptogenic focus”.

If the discharge affects the entire surface of the brain, we speak of generalized epileptic seizures; if it affects only part of the surface, it is called focal (or partial) epileptic seizures.

Syncope is defined as a transient loss of consciousness of rapid onset caused by global cerebral hypoperfusion, of short duration and spontaneous resolution.

This definition deliberately includes the cause of unconsciousness, i.e. transient cerebral hypoperfusion, which excludes causes such as stroke and concussion (the most common form of head trauma in athletes) which were until now indistinguishable from syncope proper.

There are several conditions and diseases causing loss of consciousness which in appearance resemble syncope, such as

  • generalized epilepsy without seizures;
  • panic attacks;
  • generalized anxiety;
  • acute hypoxemia due to low oxygen tension;
  • carbon monoxide poisoning.
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Thus, in the case of an epileptic seizure, a loss of consciousness similar to that occurring during syncope can occur, but this is determined by poor blood supply to the brain, while this is not the case with loss of consciousness determined by epilepsy.

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