open access

Vol 21, No 6 (2014)
Review articles
Published online: 2014-12-18
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Managing psychogenic pseudosyncope: Facts and experiences

Martijn R. Tannemaat, Roland D. Thijs, J. Gert van Dijk
DOI: 10.5603/CJ.a2014.0070
·
Cardiol J 2014;21(6):658-664.

open access

Vol 21, No 6 (2014)
Review articles
Published online: 2014-12-18

Abstract

Psychogenic pseudosyncope (PPS) is a common cause of apparent transient loss of conscious­ness (TLOC) with a dramatic impact on the quality of life. This review aims to give an overview of the definition, incidence, etiology, diagnosis, treatment, and prognosis of PPS based on a combination of literature data and personal experience. The limited literature on the subject suggests that PPS is relatively common but insufficiently recognized. PPS is probably similar to psychogenic nonepiteptic seizures (PNES), in which a long delay to diagnosis worsens the prognosis. A detailed history is of paramount importance for the diagnosis. The key feature in the history of patients with PPS is the occurrence of frequent, long attacks of apparent TLOC with closed eyes. The diagnosis is certain when a typical event is recorded during a tilt-table test with simultaneous blood pressure (BP), heart rate and video-electroencephalographic re­cordings. Home video and BP recording during an attack can be very useful. The diagnosis should be communicated to the patient in a way that is clear, understandable and does not cause offense. Although treatment options have not been investigated formally, the literature on PNES suggests that cognitive behavioral therapy is beneficial.

Abstract

Psychogenic pseudosyncope (PPS) is a common cause of apparent transient loss of conscious­ness (TLOC) with a dramatic impact on the quality of life. This review aims to give an overview of the definition, incidence, etiology, diagnosis, treatment, and prognosis of PPS based on a combination of literature data and personal experience. The limited literature on the subject suggests that PPS is relatively common but insufficiently recognized. PPS is probably similar to psychogenic nonepiteptic seizures (PNES), in which a long delay to diagnosis worsens the prognosis. A detailed history is of paramount importance for the diagnosis. The key feature in the history of patients with PPS is the occurrence of frequent, long attacks of apparent TLOC with closed eyes. The diagnosis is certain when a typical event is recorded during a tilt-table test with simultaneous blood pressure (BP), heart rate and video-electroencephalographic re­cordings. Home video and BP recording during an attack can be very useful. The diagnosis should be communicated to the patient in a way that is clear, understandable and does not cause offense. Although treatment options have not been investigated formally, the literature on PNES suggests that cognitive behavioral therapy is beneficial.

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Keywords

syncope, psychogenic pseudosyncope

About this article
Title

Managing psychogenic pseudosyncope: Facts and experiences

Journal

Cardiology Journal

Issue

Vol 21, No 6 (2014)

Pages

658-664

Published online

2014-12-18

DOI

10.5603/CJ.a2014.0070

Bibliographic record

Cardiol J 2014;21(6):658-664.

Keywords

syncope
psychogenic pseudosyncope

Authors

Martijn R. Tannemaat
Roland D. Thijs
J. Gert van Dijk

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