A sudden loss of consciousness is terrifying for both the individual who has lost consciousness and those around them. Two prevalent causes of sudden loss of consciousness are seizures and syncopal events. They may appear somewhat similar upon close examination, but these two types of events have different causes, associated risks, and treatments. Confusing one with the other can delay appropriate treatment.

By understanding the differences between seizure and syncopal events, patients will receive a more accurate diagnosis and be less likely to feel fearful, uncertain, and/or unnecessarily mismanaged.

What Is a Seizure?

The brain's electrical activity Causes Seizures

Seizures result from abnormal electrical activity in the brain. Abnormally functioning brain cells can disrupt normal brain function by generating abnormal electrical discharges that impair the patient's ability to think, move, act, or hear.

Seizures typically appear in one of four ways:

• Loss of consciousness
• Involuntary jerking action or muscle stiffness
• Staring spells
• Confused mental state after the seizure

Although epilepsy is the most common condition associated with seizure activity, many other medical conditions can cause seizure activity, such as infections, trauma (head injury), metabolic imbalance (i.e., low blood sugar), and fever.

What Is Syncope?

A temporary loss of awareness brought on by a sudden decrease in blood flow to the brain is known as syncope, commonly referred to as fainting.

The following are frequent triggers of syncope:

• prolonged standing
• abruptly changing body position
• dehydration
• stress caused by emotion
• abnormal rhythm of the heart

Once blood flow has been restored, recovery from syncope typically occurs rapidly, with most people returning to normal without lasting confusion.

Key Differences Between Seizures and Syncope

Both seizures and syncope (fainting) cause a person to lose consciousness, but the way they occur is different from one another.

1. Cause

• Abnormal electrical signals in the brain cause seizures.
• Reduced blood supply to the brain results in syncope.

2. Duration

• A seizure usually lasts between one and two minutes.
• Episodes of syncope are typically brief and resolve quickly.

3. Recovery

• Following a seizure, a person may experience confusion or drowsiness for up to several hours.
• Following syncope, an individual regains consciousness quickly and feels relatively normal.

Warning Signs Before an Episode

Early warning signs can help determine whether it was a seizure or syncope.

Some indicators may occur just before a seizure:

Some people have reported experiencing:

• Unfamiliar scents or tastes
• Intense feelings of fear or anxiety
• Lightheadedness or changes to vision

These are all called auras and indicate potential seizure activity.

Some indicators may occur just before syncope:

Common warning signs for syncope include:

• Lightheadedness or feelings of being unsteady
• Changes to the sight
• Nausea
• Profuse sweating
• Sense of feeling hot or weak

Symptoms of syncope occur due to reduced blood flow to the brain and usually improve once the person lies down.

Why Correct Diagnosis Matters

The treatment of incorrect diagnoses can place the patient at risk of being given too much medication for a diagnosis of epilepsy, treated by adding excessive medications without any benefit. Without proper evaluation of seizure disorders, the risk of injury, accidents, or uncontrolled episodes increases for the patient who presents with seizures.

This is why Insights into Seizure Disorders, Neurology stresses careful evaluation rather than assumptions.

How Doctors Diagnose the Cause

Diagnosis is made using a multi-step assessment of neurology and other medical information. The key components of the assessment/diagnostic process include:

• A thorough review of the patient's medical history
• Accounts from those who witnessed the incident
• Neurological examination by a healthcare provider
• EEG to assess seizures
• Holter Monitor (heart rhythm) to evaluate episodes of syncope
• Laboratory tests and/or imaging as necessary

In many instances, an individual may require multiple studies before a definitive diagnosis can be established.

Role of Neurology in Seizure Evaluation

The neurologist’s role in distinguishing between seizures and syncope, as well as in interpreting diagnostic test results, will help the physician identify subtle clinical patterns that would otherwise go unnoticed. 

By accurately diagnosing the condition, the physician can develop an individualised treatment plan for the patient, leading to better long-term outcomes.

Treatment When Seizures Are Confirmed

When seizures are diagnosed, the main focus of treatment is to control any unusual brain activity. One of the most commonly used medications for this purpose is Briviact 50mg Tablet, which uses brivaracetam as its active ingredient. 

This medication works by stabilising the brain's electrical activity, thus reducing seizure frequency. A doctor must prescribe this medicine and adjust the dose based on how well an individual responds to or tolerates the medicine. For seizure control to be effective, it is important to take the medication consistently.

Lifestyle Considerations After Diagnosis

Regardless of whether the diagnosis is due to a seizure disorder or a fainting disorder, improving safety can be accomplished through lifestyle changes.

Some helpful lifestyle modifications include:

• Consistent sleep patterns
• Adequate fluid intake
• Stress management techniques
• Avoidance of identified triggers
• Adherence to the prescribing provider's recommendations

Implementing these changes will reduce the risk of recurrent episodes while improving the patient's overall quality of life.

When to Seek Medical Attention Urgently

If you experience any of the following conditions, you should seek immediate medical attention:

• Multiple episodes
• Injuries sustained while unconscious
• Extended recovery time
• Chest discomfort or difficulty breathing

If you seek medical attention quickly, you reduce the risk of complications and help ensure the correct diagnosis and timely treatment.

Living With Confidence After Diagnosis

In addition to providing peace of mind by knowing your medical condition, this information can help you manage your doctor's appointments and prepare for them in a safe, secure manner.

Taking care of your medical conditions will help you lead a complete, independent life without having to worry about having repeat episodes.

Final Thoughts

Although they may seem alike at first glance, the two disorders are actually quite different. A physician should be able to differentiate between seizures and syncope based on the physical characteristics of the attack, as well as on precautions for post-ictal recovery, based on the patient's behaviour after the event.

Through behavioural therapy/intervention combined with proper medication management, patients suffering from either disorder will see a significant reduction in their symptoms and ultimately an improved quality of life.