Diagnostic Questions to Determine Whether Loss of Consciousness Is Due to Seizures or Syncope

[select name="v1" value="not present / not known=0|present=2"]<-- Waking with cut tongue
[select name="v2" value="not present / not known=0|present=1"]<-- Abnormal behavior noted*
[select name="v3" value="not present / not known=0|present=1"]<-- Loss of consciousness with emotional stress
[select name="v4" value="not present / not known=0|present=1"]<-- Postictal confusion
[select name="v5" value="not present / not known=0|present=1"]<-- Head turning to one side during loss of consciousness
[select name="v6" value="not present / not known=0|present=1"]<-- Prodromal deja vu or jamais vu
[select name="v7" value="not present / not known=0|present=-2"]<-- Any presyncope
[select name="v8" value="not present / not known=0|present=-2"]<-- Loss of consciousness with prolonged standing or sitting
[select name="v9" value="not present / not known=0|present=-2"]<-- Diaphoresis before a spell

score->[calc value="(v1)+(v2)+(v3)+(v4)+(v5)+(v6)+(v7)+(v8)+(v9)"]

*[comment memo="One or more of witnessed amnesia for abnormal behavior, witnessed unresponsiveness, unusual posturing or limb jerking."]

[comment memo="The patient has seizures if the point score is more than equal to 1, and syncope if the point score is less than 1. Correctly classified 94% of patients, diagnosing seizures with 94% sensitivity and 94% specificity"]

[comment memo="Ref: Sheldon R, Rose S, Ritchie D, Connolly SJ, Koshman ML, Lee MA, Frenneaux M, Fisher M, Murphy W. Historical criteria that distinguish syncope from seizures. Journal of the American College of Cardiology. 2002 Jul 3;40(1):142-8. Available from: https://www.sciencedirect.com/science/article/pii/S073510970201940X#TBLFN1"]
<-- Waking with cut tongue
<-- Abnormal behavior noted*
<-- Loss of consciousness with emotional stress
<-- Postictal confusion
<-- Head turning to one side during loss of consciousness
<-- Prodromal deja vu or jamais vu
<-- Any presyncope
<-- Loss of consciousness with prolonged standing or sitting
<-- Diaphoresis before a spell

score->(v1)+(v2)+(v3)+(v4)+(v5)+(v6)+(v7)+(v8)+(v9)

*One or more of witnessed amnesia for abnormal behavior, witnessed unresponsiveness, unusual posturing or limb jerking.

The patient has seizures if the point score is more than equal to 1, and syncope if the point score is less than 1. Correctly classified 94% of patients, diagnosing seizures with 94% sensitivity and 94% specificity

Ref: Sheldon R, Rose S, Ritchie D, Connolly SJ, Koshman ML, Lee MA, Frenneaux M, Fisher M, Murphy W. Historical criteria that distinguish syncope from seizures. Journal of the American College of Cardiology. 2002 Jul 3;40(1):142-8. Available from: https://www.sciencedirect.com/science/article/pii/S073510970201940X#TBLFN1

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 1, 13 form elements, 64 boilerplate words, 9 drop downs, 3 comments, 1 calculations, 9 total clicks
Questions/General site feedback · Help Ticket

Send Feedback for this SOAPnote

Your email address will not be published. Required fields are marked *

More SOAPnotes by this Author: