Abstracts

Rationale: The causes of transient loss of consciousness (TLOC) include mainly Syncope and Epilepsy. These two diseases are totally different in pathophysiology but diagnostics are not easily. A diagnosis of epilepsy makes a strong impact on the life of patients. It influences work and social life greatly. And cardiogenic syncope, one kind of syncope, might lead to fatal status or sudden death. Therefore, we should provide a correct diagnosis for patients with TLOC and distinguish between epilepsy and syncope. However, it has not established clear diagnostic methods or essential examinations for diagnosing TLOC yet. The aim of this study is to analyze the clinical information of TLOC, find the characteristics and help to make an accurate diagnosis.  Methods: We explored the patients with TLOC that had detailed examinations from both epileptology and cardiology in our institute between 01/2011 and 03/2019 at the age of 19 and more. And we reviewed the situations, aura, duration time and time to recovery at the time of the paroxysmal events, the contents of examinations both epileptology and cardiology and the final diagnosis retrospectively. We got the clinical information from the electrical medical records.  Results: We finally identified 65 patients for this study. The patients were distinguished to four diagnoses; syncope (31, 47.7%), epilepsy (13, 20%), psychogenic non-epileptic seizure (PNES) (4, 6.2%) and unknown etiology (17, 26.2%). In the situation at the paroxysmal events, watching TV, sleeping and bathing would be characteristics of epilepsy group. These situations were not in syncope group. In Aura, there were always signs at the time of paroxysmal events in syncope group. These signs were mostly visual abnormalities, mood discomfort, faintness and dizziness. On the other hand, there were mostly no sign in epilepsy and unknown etiology groups. In duration time at the time of paroxysmal events, there was a tendency that PNES was longer than the other three groups. In time to recovery, there was a tendency that the patients of epilepsy group took longer time than the other three groups. Most patients of the other groups recovered from loss of consciousness immediately.  Conclusions: In present study, 47.7% of patients with TLOC were diagnosed to syncope and 20% were diagnosed to epilepsy. In the analysis of the clinical information, there would be that syncope would always had aura at the time of paroxysmal events and epilepsy patient with TLOC took longer time to recovery from loss of consciousness than syncope patients.  Funding: No funding