Which of the following features helps in distinguishing seizures from syncope?
Ans. d. Physical weakness with clear sensorium (Ref: Harrison 19/e p2551, 18/e p3260-3261)Urinary incontinence is rare in syncope as compared to seizures.FeaturesSeizureSyncopeImmediate precipitating factorsUsually noneEmotional stress, Valsalva, orthostatic hypotension, cardiac etiologiesPremonitory symptomsNone or aura (e.g. odd odor)Tiredness, nausea, diaphoresis, tunneling of visionPosture at onsetVariableUsually erectTransition to unconsciousnessOften immediateGradual over secondsDuration of unconsciousnessMinutesSecondsDuration of tonic or clonic movements30-60 sNever more than 15 sFacial appearance during eventCyanosis, frothing at mouthPallorDisorientation and sleepiness after eventMany minutes to hours<5 minAching of muscles after eventOftenSometimesBiting of tongueSometimesRarelyIncontinenceSometimesSometimesHeadacheSometimesRarely
Loss of consciousness
Injury due to fall
Urinary incontinence
Physical weakness with clear sensorium
Seizures and Epilepsy