Falls, faints, fits and funny turns.
In this practically oriented review, we will outline the clinical approach of patients with falls due to an impairment or loss of consciousness. Following a set of definitions, we describe the salient clinical features of disorders leading to such falls. Among falls caused by true loss of consciousness, we separate the clinical characteristics of syncopal falls (due to reflex syncope, hypovolemia, orthostatic hypotension or cardiac syncope) from falls due to other causes of transient unconsciousness, such as seizures. With respect to falls caused by an apparent loss of consciousness, we discuss the presentation of cataplexy, drop attacks, and psychogenic falls. Particular emphasis will be laid upon crucial features obtained by history taking for distinguishing between the various conditions that cause or mimic a transient loss of consciousness.
Thijs
Roland D
RD
Dept. of Neurology and Clinical Neurophysiology, Leiden University Medical Centre, Postal Zone J03-R, 9600, 2300 RC Leiden, The Netherlands. r.d.thijs@lumc.nl
Bloem
Bastiaan R
BR
van Dijk
J Gert
JG
D000058:Accidental Falls / Q000706:statistics & numerical data*; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D002385:Cataplexy / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D012791:Shy-Drager Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D013575:Syncope / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D014474:Unconsciousness / Q000209:etiology* / Q000503:physiopathology*