Aug 29, 2014
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Hello friends,

The Question:
A 60-year old male is brought to the ER after passing out at home. He was watching TV while seated in an armchair when he suddenly passed out without any warning signs. He was unconscious for several minutes and displayed several muscle jerks while unconscious. He had an MI 6 months ago. On exam, his blood pressure is 130/85, pulse is 80/min with frequent ectopic beats, and a 2/6 holosystolic murmur radiating to the axilla is heard. What is the most likely cause of this event?

A. Arrhythmia
D. Seizure


Answer to above + My question:
The answer is A. I don't understand why "muscle jerks while unconscious" automatically doesn't make it seizure. You don't get muscle jerks due to cardiogenic syncope.

Thank you!
 

Pisiform

Oh Crap!!!
7+ Year Member
Nov 26, 2009
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because he has CV etiology .. Hx of MI and murmur. Many seizure-like activity have CV cause and are often misdiagnosed as epilepsy. Thats why we use loop recorders to monitor cardiac activity over long time
 
Apr 12, 2014
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You may

Syncope is a sudden, brief loss of consciousness (LOC) with loss of postural tone followed by spontaneous revival. The patient is motionless and limp and usually has cool extremities, a weak pulse, and shallow breathing. Sometimes brief involuntary muscle jerks occur, resembling a seizure.
http://www.merckmanuals.com/professional/cardiovascular-disorders/symptoms-of-cardiovascular-disorders/syncope

Or like the Oxford Handbook of Clinical Medicine taught me: Not everything that twitches is epilepsy.

You want to diagnose seizure? Look for postictal state