František Cibulčík
Syncope is a symptom defined as a sudden, temporary unconsciousness associated with the loss of postural tonus conditioned by brain poerfusion disorder. the basic diagnostic procedure of patients with syncope conprises a therough history, clinical examination and ECG. With these procedures the correct diagnosis is established in 45 % of patients and in further 8 % the likely diagnosis can be established which can be later confirmed by target tests. In case of unclear aetiology of the syncope there are several ways of diagnostic procedures. If the neurological finding is without any pathological changes, more sophisticated medical and cardiologic investigations can be used (head upright tilt table test, echocardiography, Holter monitoring, etc.). From the neurologist`s point of view the way of diagnostic procedures directed at patients with neurological symptomatology is the most important. Permanent neurological finding is seen mostly in patients with a asympathicotonic type of orthostatic syncore (primary degenerative diseases and secondary disorders in DM). The presence of clinical pathology in neurological examinations helps in diagnostics as well as electrophysiological examining methods (electromyography).EEG together with head upright tilt table test are the crucial methods in troublesome differential diagnostics of epilepsy and syncope, mostly s.c. convulsive syncope.
Key word: syncope, neurocardiogenous syncope, electromyography, electroencephalography, epilepsy