inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1inovmed-72Research ArticleОБЗОРЫREVIEWSПЕРВИЧНОЕ ОБСЛЕДОВАНИЕ ПАЦИЕНТА – ОСНОВА ДИФФЕРЕНЦИАЛЬНОГО ДИАГНОЗА ПРЕХОДЯЩИХ ПОТЕРЬ СОЗНАНИЯPRIMARY PATIENT ASSESSMENT IS A BASIC DIFFERENTIAL DIAGNOSIS FOR INTERMITTENT APSYCHIAhttps://orcid.org/0000-0002-4866-0345ГоловинаГ. А.GolovinaG. A.ggolovina.70@mail.ruНаучно-исследовательский институт – Краевая клиническая больница № 1 им. проф. С.В. Очаповского Министерства здравоохранения Краснодарского краяРоссияScientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of HealthRussian Federation201730062017624553Copyright © Головина Г.А., 20172017Головина Г.А.Golovina G.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/72

Рассматриваются вопросы дифференциального диагноза преходящих потерь сознания, основанного на первичном обследовании. Особое значение уделяется анамнестическим критериям, активной ортостатической пробе, электрокардиограмме.

We assess differential diagnosis for intermittent apsychia considering primarily examinations. Special attention is paid to anamnestic criteria, active orthostatic trial, ECG tracing.

нейромедиаторные синкопыортостатическая гипотониякардиальные синкопыэпилепсияneutrally mediated syncopesorthostatic hypotonycardial syncopesepilepsyReferencesMoya A., Sutton R., Ammirati F. et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 2009; 30: 2631 - 71.Moya A., Sutton R., Ammirati F. et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 2009; 30: 2631 - 71.Brignole M., Alboni P., Benditt D.G. et al. Guidelines on management (diagnosis and treatment) of syncope-Update 2004. Europace 2004; 6: 467 - 537.Brignole M., Alboni P., Benditt D.G. et al. Guidelines on management (diagnosis and treatment) of syncope-Update 2004. Europace 2004; 6: 467 - 537.Ammirati F., Colivicchi F., Santini M. Diagnosing syncope in clinical practice. Implementation of a simplified diagnostic algorithm in a multicentre prospective trial- the OESIL 2 study (Osservatorio Epidemiologico della Sincope nel Lazio). Eur Heart J 2000; 21: 935 - 40.Ammirati F., Colivicchi F., Santini M. Diagnosing syncope in clinical practice. Implementation of a simplified diagnostic algorithm in a multicentre prospective trial- the OESIL 2 study (Osservatorio Epidemiologico della Sincope nel Lazio). Eur Heart J 2000; 21: 935 - 40.Sorajja D., Conti R. Sincope while driving: clinical characteristics, etiologies, and prognosis. Cardiosource 2006; available at www.cardiosource.com.Sorajja D., Conti R. Sincope while driving: clinical characteristics, etiologies, and prognosis. Cardiosource 2006; available at www.cardiosource.com.Soteriades E.S., Evans J.C., Larson M.G. et al. Incidence and prognosis of syncope. N Engl J Med 2002; 347: 878 -85.Soteriades E.S., Evans J.C., Larson M.G. et al. Incidence and prognosis of syncope. N Engl J Med 2002; 347: 878 -85.Chen L.Y., Gersh B.J., Hodge D.O. et al. Prevalence and clinical outcomes of patients with multiple potential causes of syncope. Mayo Clin Proc 2003; 78: 414 - 20.Chen L.Y., Gersh B.J., Hodge D.O. et al. Prevalence and clinical outcomes of patients with multiple potential causes of syncope. Mayo Clin Proc 2003; 78: 414 - 20.Colman N., Nahm K., van Dijk J.G. et al. Diagnostic value of history taking in reflex syncope. Clin Auton Res 2004; 14(Suppl 1): i37 - i44.Colman N., Nahm K., van Dijk J.G. et al. Diagnostic value of history taking in reflex syncope. Clin Auton Res 2004; 14(Suppl 1): i37 - i44.Driscoll D.J., Jacobsen S.J., Porter C.J. et al. Syncope in children and adolescents. J Am Coll Cardiol 1997; 29: 1039 - 45.Driscoll D.J., Jacobsen S.J., Porter C.J. et al. Syncope in children and adolescents. J Am Coll Cardiol 1997; 29: 1039 - 45.Prett J., Fleisher G. Syncope in children and adolescents. Pediatr Emerg Care 1989; 5: 80 - 2.Prett J., Fleisher G. Syncope in children and adolescents. Pediatr Emerg Care 1989; 5: 80 - 2.Mclntosh S.J., Da Costa D., Kenny R.A. Outcome of an integrated approach to the investigation of dizziness, falls and syncope in elderly patients referred to a syncope clinic. Age Ageing 1993; 22: 53 - 5.Mclntosh S.J., Da Costa D., Kenny R.A. Outcome of an integrated approach to the investigation of dizziness, falls and syncope in elderly patients referred to a syncope clinic. Age Ageing 1993; 22: 53 - 5.Colman1 N., Bakker A., Linzer M. et al. Value of history-taking in syncope patients: in whom to suspect long QT syndrome? Europace 2009 11(7): 937 - 43.Colman1 N., Bakker A., Linzer M. et al. Value of history-taking in syncope patients: in whom to suspect long QT syndrome? Europace 2009 11(7): 937 - 43.Del Rosso A., Alboni P., Brignole M. et al. Relation of clinical presentation of syncope to the age of patients. Am J Cardiol 2005; 10: 1431-5.Del Rosso A., Alboni P., Brignole M. et al. Relation of clinical presentation of syncope to the age of patients. Am J Cardiol 2005; 10: 1431-5.Hermosillo A.G., Falcon J.C., Marquez M.F. et al. Positive head-up tilt table test in patients with the long QT syndrome. Europace 1999; 1: 213 - 7.Hermosillo A.G., Falcon J.C., Marquez M.F. et al. Positive head-up tilt table test in patients with the long QT syndrome. Europace 1999; 1: 213 - 7.Hoefnagels W.A.J., Padberg G.W., Overweg J. et al. Transient loss of consciousness: the value of the history for distinguishing seizure from syncope. J Neurol 1991; 238: 39 - 43.Hoefnagels W.A.J., Padberg G.W., Overweg J. et al. Transient loss of consciousness: the value of the history for distinguishing seizure from syncope. J Neurol 1991; 238: 39 - 43.Kenny R.A. Syncope in the elderly: diagnosis, evaluation, and treatment. J Cardiovasc Electrophysiol 2003; 14: S74 - S77.Kenny R.A. Syncope in the elderly: diagnosis, evaluation, and treatment. J Cardiovasc Electrophysiol 2003; 14: S74 - S77.Romme J.J.C.M., Van Dijk N., Boer K.R. et al. Diagnosing vasovagal syncope based on quantitative history-taking: validation of the Calgary Syncope Symptom Score. European Heart Journal 2009; 30: 2888 - 96.Romme J.J.C.M., Van Dijk N., Boer K.R. et al. Diagnosing vasovagal syncope based on quantitative history-taking: validation of the Calgary Syncope Symptom Score. European Heart Journal 2009; 30: 2888 - 96.Sutton R., Bloomfield DM. Indications, methodology, and classification of results of tilt-table testing. Am J Cardiol 1999; 84: 10Q - 20Q.Sutton R., Bloomfield DM. Indications, methodology, and classification of results of tilt-table testing. Am J Cardiol 1999; 84: 10Q - 20Q.Van Dijk N., Boer K.R., Colman N. et al. High diagnostic yield and accuracy of history, physical examination, and ECG in patients with transient loss of consciousness in FAST: The Fainting Assessment Study. J Cardiovasc Electrophysiol 2008; 19(1): 48 - 55.Van Dijk N., Boer K.R., Colman N. et al. High diagnostic yield and accuracy of history, physical examination, and ECG in patients with transient loss of consciousness in FAST: The Fainting Assessment Study. J Cardiovasc Electrophysiol 2008; 19(1): 48 - 55.Zaidi A., Clough P., Cooper P. Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause. J Am Coll Cardiol 2000; 36: 181 - 4.Zaidi A., Clough P., Cooper P. Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause. J Am Coll Cardiol 2000; 36: 181 - 4.Zysko D., Gajek J., Sciborski R. et al. The pattern of activation of the sympathetic nervous system during tilt-induced syncope. Europace 2007; 9: 225 - 7.Zysko D., Gajek J., Sciborski R. et al. The pattern of activation of the sympathetic nervous system during tilt-induced syncope. Europace 2007; 9: 225 - 7.Тюрина Т.В. Особенности нейрокардиогенных обмороков разных типов у больных с нарушениями регуляции артериального давления. Вестник аритмологии 2004; 37: 14 - 9.Тюрина Т.В. Особенности нейрокардиогенных обмороков разных типов у больных с нарушениями регуляции артериального давления. Вестник аритмологии 2004; 37: 14 - 9.Alboni P., Brignole M et al. Is vasovagal a disease? Europace 2007; 9: 83 - 7.Alboni P., Brignole M et al. Is vasovagal a disease? Europace 2007; 9: 83 - 7.Ammirati F., Colivicchi F., Santini M. Permanent Cardiac Pacing versus medical treatment for the prevention of recurrent vasovagal syncope. A multicenter, randomized, controlled trial. Circulation 2001; 104: 52 - 7.Ammirati F., Colivicchi F., Santini M. Permanent Cardiac Pacing versus medical treatment for the prevention of recurrent vasovagal syncope. A multicenter, randomized, controlled trial. Circulation 2001; 104: 52 - 7.Brignole M., Sutton R., Menozzi C. et al. Early application of an Implantable Loop Recorder allows a mechanism-based effective therapy in patients with recurrent suspected neurally-mediated syncope. Eur Heart J 2006; 27: 1085-92.Brignole M., Sutton R., Menozzi C. et al. Early application of an Implantable Loop Recorder allows a mechanism-based effective therapy in patients with recurrent suspected neurally-mediated syncope. Eur Heart J 2006; 27: 1085-92.Grubb B.P. Neurocardiogenic syncope. N Engl J Med 2005; 352: 1004 - 10.Grubb B.P. Neurocardiogenic syncope. N Engl J Med 2005; 352: 1004 - 10.Хирманов В.Н., Русанов О.А., Джармукли Н. Этиология и прогноз синкопальных состояний у пациентов старше 35 лет. Кардиоваскулярная терапия и профилактика, 2007; 6(1): 84 - 8.Хирманов В.Н., Русанов О.А., Джармукли Н. Этиология и прогноз синкопальных состояний у пациентов старше 35 лет. Кардиоваскулярная терапия и профилактика, 2007; 6(1): 84 - 8.Brignole M., Menozzi C., Bartoletti A. et al. A new management of syncope. Prospective systematic guideline -based evaluation of patients referred urgently to general hospitals. Eur Heart J 2006; 27: 76 - 82.Brignole M., Menozzi C., Bartoletti A. et al. A new management of syncope. Prospective systematic guideline -based evaluation of patients referred urgently to general hospitals. Eur Heart J 2006; 27: 76 - 82.Grubb B., Temesy-Armos P., Moore J. et al. Head-upright tilt-table testing in evaluation and management of the malignant vasovagal syndrome. Am J Cardiol 1992; 69: 904 - 8.Grubb B., Temesy-Armos P., Moore J. et al. Head-upright tilt-table testing in evaluation and management of the malignant vasovagal syndrome. Am J Cardiol 1992; 69: 904 - 8.Milstein S., Buetikofer J., Lesser J. et al. Cardiac asystole: A manifestation of neurally mediated hypotension-bradycardia. J Am Coll Cardiol 1989; 14: 1626 - 32.Milstein S., Buetikofer J., Lesser J. et al. Cardiac asystole: A manifestation of neurally mediated hypotension-bradycardia. J Am Coll Cardiol 1989; 14: 1626 - 32.Tan M.P., Newton J.L., Chadwick T.J. et al. The relationship between carotid sinun hypersensitivity, orthostatic hypotension, and vasovagal syncope: a case-control stady. Europace 2008; 10: 1400 - 5.Tan M.P., Newton J.L., Chadwick T.J. et al. The relationship between carotid sinun hypersensitivity, orthostatic hypotension, and vasovagal syncope: a case-control stady. Europace 2008; 10: 1400 - 5.Strickberger S.A., Benson D.W., Biaggioni I., et al. AHA/ACCF scientific statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation In Collaboration With the Heart Rhythm Society. J Am Coll Cardiol 2006; 47: 473 - 84.Strickberger S.A., Benson D.W., Biaggioni I., et al. AHA/ACCF scientific statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation In Collaboration With the Heart Rhythm Society. J Am Coll Cardiol 2006; 47: 473 - 84.Hazeldine S., Przemioslo R. An unusual cause of syncope. Q J Med 2013; 106: 269 - 70.Hazeldine S., Przemioslo R. An unusual cause of syncope. Q J Med 2013; 106: 269 - 70.Вейн А.М., Вознесенская Т.Г., Голубев В.Л. и др. Заболевания вегетативной нервной системы. Руководство для врачей. Под ред. профессора Вейна А.М. -М.: Медицина, 1991. стр.458 - 494.Вейн А.М., Вознесенская Т.Г., Голубев В.Л. и др. Заболевания вегетативной нервной системы. Руководство для врачей. Под ред. профессора Вейна А.М. -М.: Медицина, 1991. стр.458 - 494.Ерохина Л.Г. и соавт. К клинике и патогенезу острого расширения желудка и синкопальных состояний при глотании. Сов. мед. 1982; 9: 19 - 24.Ерохина Л.Г. и соавт. К клинике и патогенезу острого расширения желудка и синкопальных состояний при глотании. Сов. мед. 1982; 9: 19 - 24.Kakuchi H, Sato N, Kawamura Y. Swallow syncope associated with complete atrioventricular block and vasovagal syncope. Heart 2000; 83: 702 - 4.Kakuchi H, Sato N, Kawamura Y. Swallow syncope associated with complete atrioventricular block and vasovagal syncope. Heart 2000; 83: 702 - 4.Акимов Г.А., Ерохина Л.Г, Стыкан О.А. Неврология синкопальных состояний. М.: Медицина, 1987.Акимов Г.А., Ерохина Л.Г, Стыкан О.А. Неврология синкопальных состояний. М.: Медицина, 1987.Kerr A., Derbes V.J. The syndrome of cough syncope. Ann Intern Med 1953; 39: 1240 - 53.Kerr A., Derbes V.J. The syndrome of cough syncope. Ann Intern Med 1953; 39: 1240 - 53.El-Osta H., Ashfaq S. Cough-induced syncope as an unusual manifestation of pericardial effusion. Kansas Journal of Medicine 2008; 3: 53 - 5.El-Osta H., Ashfaq S. Cough-induced syncope as an unusual manifestation of pericardial effusion. Kansas Journal of Medicine 2008; 3: 53 - 5.Bonekat H.W., Miles R.M., Stoats B.A. Smoking andcough syncope: follow up in 45 cases. Int J Addict 1987; 22: 413 - 9.Bonekat H.W., Miles R.M., Stoats B.A. Smoking andcough syncope: follow up in 45 cases. Int J Addict 1987; 22: 413 - 9.Deshmukh A., Schuller D. Cough syncope in a patient with severe chronic obstructive pulmonary disease. Respiratory Medicine CME 2008; 1: 120 - 2.Deshmukh A., Schuller D. Cough syncope in a patient with severe chronic obstructive pulmonary disease. Respiratory Medicine CME 2008; 1: 120 - 2.Sharpey-Schafer E.P. The mechanism of syncope after coughing Br Med J 1953; 2: 860-3.Sharpey-Schafer E.P. The mechanism of syncope after coughing Br Med J 1953; 2: 860-3.Morice A.H., Committee Members. The diagnosis and management of chronic cough. Eur espir J 2004; 24: 481.Morice A.H., Committee Members. The diagnosis and management of chronic cough. Eur espir J 2004; 24: 481.Jhanjee R., Van Dijk J.G., Sakaguchi S., et al. Syncope in аdults: terminology, classification, and diagnostic strategy. Pacing Clin Electrophysiol 2006; 29(2): 1160 - 9.Jhanjee R., Van Dijk J.G., Sakaguchi S., et al. Syncope in аdults: terminology, classification, and diagnostic strategy. Pacing Clin Electrophysiol 2006; 29(2): 1160 - 9.Гуков А.О., Жданов А.М. Синдром каротидного синуса и вазовагальные синкопе. Терапевтический архив 2000; 12: 72 - 5.Гуков А.О., Жданов А.М. Синдром каротидного синуса и вазовагальные синкопе. Терапевтический архив 2000; 12: 72 - 5.Gupta V., Lipsitz L.A. Orthostatic hypotension in the elderly: diagnosis and treatment. The American Journal of Medicine 2007; 120: 841 - 7.Gupta V., Lipsitz L.A. Orthostatic hypotension in the elderly: diagnosis and treatment. The American Journal of Medicine 2007; 120: 841 - 7.Wieling W., Ganzeboom K.S., Saul J.P. Reflex syncope in children and adolescents. Heart 2004; 90: 1094 - 100.Wieling W., Ganzeboom K.S., Saul J.P. Reflex syncope in children and adolescents. Heart 2004; 90: 1094 - 100.van Dijk N., Immink R.V., Mulder B.J. et al. Orthostatic blood pressure control in Marfan’s syndrome. Europace 2005; 7: 25 - 7.van Dijk N., Immink R.V., Mulder B.J. et al. Orthostatic blood pressure control in Marfan’s syndrome. Europace 2005; 7: 25 - 7.Ungar A., Mussi C., Del Rossi A. et al. Diagnosis and characteristics of syncope in older patients referred to geriatrics departments. J Am Geriatr Soc 2006; 54: 1531 - 6.Ungar A., Mussi C., Del Rossi A. et al. Diagnosis and characteristics of syncope in older patients referred to geriatrics departments. J Am Geriatr Soc 2006; 54: 1531 - 6.Wieling W., Krediet P., van Dijk N. et al. Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (Lond) 2007; 112: 157 - 65.Wieling W., Krediet P., van Dijk N. et al. Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (Lond) 2007; 112: 157 - 65.Alboni P., Brignole M., Menozzi C., et al. The diagnostic value of history in patients with syncope with or without heart disease. J Am Coll Cardiol 2001; 37: 1921 - 8.Alboni P., Brignole M., Menozzi C., et al. The diagnostic value of history in patients with syncope with or without heart disease. J Am Coll Cardiol 2001; 37: 1921 - 8.Школьникова М.А., Харлап М.С., Ильдарова Р.А. Генетически детерминированные нарушения ритма сердца. Российский кардиологический журнал 2011; 1(87): 8 - 25.Школьникова М.А., Харлап М.С., Ильдарова Р.А. Генетически детерминированные нарушения ритма сердца. Российский кардиологический журнал 2011; 1(87): 8 - 25.Crotti L., Celano G., Dagradi F., et al. Congenital long QT syndrome. Orphanet J Rare Diseases 2008, 3: 18.Crotti L., Celano G., Dagradi F., et al. Congenital long QT syndrome. Orphanet J Rare Diseases 2008, 3: 18.Zareba W., Moss A.J., Schwartz P.J. et al. Influence of genotype on the clinical course of the long-QT syndrome. International Long-QT Syndrome Registry Research Group. N Engl J Med. 1998; 339: 960 - 5.Zareba W., Moss A.J., Schwartz P.J. et al. Influence of genotype on the clinical course of the long-QT syndrome. International Long-QT Syndrome Registry Research Group. N Engl J Med. 1998; 339: 960 - 5.Schwartz P.J., Spazzolini C., Crotti L., et al. The Jervell and Lange-Nielsen Syndrome. Natural history, molecular basis, and clinical outcome. Circulation 2006; 113: 783 - 90.Schwartz P.J., Spazzolini C., Crotti L., et al. The Jervell and Lange-Nielsen Syndrome. Natural history, molecular basis, and clinical outcome. Circulation 2006; 113: 783 - 90.Vincent G.M., Timothy K.W., Leppert M., Keating M. The spectrum of symptoms and QT intervals in carriers of the gene for the long QT syndrome. N Engl J Med. 1992; 327: 846 - 852.Vincent G.M., Timothy K.W., Leppert M., Keating M. The spectrum of symptoms and QT intervals in carriers of the gene for the long QT syndrome. N Engl J Med. 1992; 327: 846 - 852.Priori S.G., Napolitano C., Schwartz P.J. Low penetrance in the long-QT syndrome: clinical impact. Circulation. 1999; 99: 529 - 533.Priori S.G., Napolitano C., Schwartz P.J. Low penetrance in the long-QT syndrome: clinical impact. Circulation. 1999; 99: 529 - 533.AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram Part IV: The ST Segment, T and U Waves, and the QT Interval A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society Endorsed by the International Society for Computerized Electrocardiology. Pentti M. Rautaharju, MD, PhD; Borys Surawicz, MD, FAHA, FACC; Leonard S. Gettes, MD, FAHA, FACC. J.Am.Coll.Cardiol. published online Feb 19, 2009.AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram Part IV: The ST Segment, T and U Waves, and the QT Interval A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society Endorsed by the International Society for Computerized Electrocardiology. Pentti M. Rautaharju, MD, PhD; Borys Surawicz, MD, FAHA, FACC; Leonard S. Gettes, MD, FAHA, FACC. J.Am.Coll.Cardiol. published online Feb 19, 2009.Schimpf R., Wolpert Ch., Gaita F. et al. Short QT syndrome. Cardiovascular research. 2005; 67: 357 - 64.Schimpf R., Wolpert Ch., Gaita F. et al. Short QT syndrome. Cardiovascular research. 2005; 67: 357 - 64.Leenhard A., Lucet V., Denjoy I. et al. Cateholaminergic polymorphic ventricular tachycardia in children. A 7-year follow up of 21 patients. Circulation. 1995; 91: 1512 - 19.Leenhard A., Lucet V., Denjoy I. et al. Cateholaminergic polymorphic ventricular tachycardia in children. A 7-year follow up of 21 patients. Circulation. 1995; 91: 1512 - 19.Gussak I., Antzelevitch C., Bjerregaard P. et al. The Brugada syndrome: clinical, electrophysiologic and genetic aspects. JACC, 1999; 33(1); 5 - 15.Gussak I., Antzelevitch C., Bjerregaard P. et al. The Brugada syndrome: clinical, electrophysiologic and genetic aspects. JACC, 1999; 33(1); 5 - 15.French J.A., Kanner A.M., Bautista J. et al. Efficacy and tolerability of the new antiepileptic drugs II: Treatment of refractory epilepsy. Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2004; 62: 1261 - 73.French J.A., Kanner A.M., Bautista J. et al. Efficacy and tolerability of the new antiepileptic drugs II: Treatment of refractory epilepsy. Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2004; 62: 1261 - 73.Scheepers B., Clough P., Pickles C. The misdiagnosis of epilepsy: findings of a population study. Seizure 1998; 7: 403 - 6.Scheepers B., Clough P., Pickles C. The misdiagnosis of epilepsy: findings of a population study. Seizure 1998; 7: 403 - 6.King M.A., Newton M.R., Jackson G.D., et al. Epileptology of the first-seizure resentation: a clinical, electroencephalographic, and magnetic resonance imaging study of 300 consecutive patients. Lancet 1998; 352: 1007 - 11.King M.A., Newton M.R., Jackson G.D., et al. Epileptology of the first-seizure resentation: a clinical, electroencephalographic, and magnetic resonance imaging study of 300 consecutive patients. Lancet 1998; 352: 1007 - 11.Grubb B.P., Gerard G., Roush K., et al. Differentiation of convulsive syncope and epilepsy with head-up tilt testing. Ann Intern Med 1991; 115: 871 - 6.Grubb B.P., Gerard G., Roush K., et al. Differentiation of convulsive syncope and epilepsy with head-up tilt testing. Ann Intern Med 1991; 115: 871 - 6.Linzer M., Grubb B.P., Ho S., et al. Cardiovascular causes of loss of consciousness in patients with presumed epilepsy: a cause of the increased sudden death rate in people with epilepsy? Am J Med 1994; 96: 146 - 54.Linzer M., Grubb B.P., Ho S., et al. Cardiovascular causes of loss of consciousness in patients with presumed epilepsy: a cause of the increased sudden death rate in people with epilepsy? Am J Med 1994; 96: 146 - 54.Petkar S., Jackson, Fitzpatrick A. Management of blackouts and misdiagnosis of epilepsy and falls. Clin Med 2005; 5: 514 - 20.Petkar S., Jackson, Fitzpatrick A. Management of blackouts and misdiagnosis of epilepsy and falls. Clin Med 2005; 5: 514 - 20.Marrison V.K., Parry S.W. A case of nocturnal fainting: supine vasovagal syncope. Europace 2007; 9: 835 - 6.Marrison V.K., Parry S.W. A case of nocturnal fainting: supine vasovagal syncope. Europace 2007; 9: 835 - 6.Ruiter J.H., Barrett M. Permanent cardiac pacing for neurocardiogenic syncope. Neth Heart J 2008; 16(suppl 1): S15 - S19.Ruiter J.H., Barrett M. Permanent cardiac pacing for neurocardiogenic syncope. Neth Heart J 2008; 16(suppl 1): S15 - S19.Kowacs P.A., Barros da Silva E. Jhnior, Laroca dos Santos H., Blattes da Rocha S., Simão Ch., Sousa de Meneses M, Oleschko Arruda W. Syncope or epileptic fits? Some examples of diagnostic confounding factors Arq Neuropsiquiatr 2005; 63(3-A): 597 - 600.Kowacs P.A., Barros da Silva E. Jhnior, Laroca dos Santos H., Blattes da Rocha S., Simão Ch., Sousa de Meneses M, Oleschko Arruda W. Syncope or epileptic fits? Some examples of diagnostic confounding factors Arq Neuropsiquiatr 2005; 63(3-A): 597 - 600.Lempert T. Recognizing syncope: pitfalls and surprises J R Soc Med 1996; 89: 372 - 5.Lempert T. Recognizing syncope: pitfalls and surprises J R Soc Med 1996; 89: 372 - 5.Lempert T., Bauer M., Schmidt D. Syncope: a videometric analysis of 56 episodes of transient cerebral hypoxia. Ann Neurol. 1994; 36(2): 233 - 7.Lempert T., Bauer M., Schmidt D. Syncope: a videometric analysis of 56 episodes of transient cerebral hypoxia. Ann Neurol. 1994; 36(2): 233 - 7.Lin J.T., Ziegler D.K., Lai C.W., Bayer W. Convulsive syncope in blood donors. Ann Neurol 1982; 11: 525-8.Lin J.T., Ziegler D.K., Lai C.W., Bayer W. Convulsive syncope in blood donors. Ann Neurol 1982; 11: 525-8.Stephenson J.B.P. Fits and Faints. London: Mac Keith Press, 1990.Stephenson J.B.P. Fits and Faints. London: Mac Keith Press, 1990.

The authors declare that there are no conflicts of interest present.