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Volume 13, Issue 1, Pages 35-40 (May 2010)


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Transient loss of consciousness misdiagnosed as epileptic seizure: About one case

Lise Duggan, RN, GDipNurs, GCertEmergNurs, BNScCorresponding Author Informationemail address

Received 14 February 2009; received in revised form 24 September 2009; accepted 12 November 2009.

Abstract 

Syncopal events resulting in a transient loss of consciousness (TLOC) are a common Emergency Department (ED) presentation. However, successful identification of syncopal events as the cause of a TLOC can be a diagnostic challenge. In this paper, the case of a 54-year-old man presenting to the ED with TLOC and seizure-like activity will be examined. In addition to the patient's presentation, management and disposition, the underlying pathophysiology of the patient's diagnosis is also reviewed. In this case, the patient's TLOC episodes were initially misdiagnosed as first presentation epileptic seizure. The patient, Mr A, may have gone on to undergo unnecessary testing and potentially dangerous pharmacotherapy. A key factor in this case was accurate initial and ongoing emergency nursing assessment that eventually highlighted the true cause of Mr A's TLOC. This case highlights the crucial role of emergency nurses and demonstrates that accurate nursing assessment can improve diagnostic accuracy and contribute towards positive patient outcomes.

Austin Health, Emergency Department, 145 Studley Road, Heidelberg 3084, Victoria, Australia

Corresponding Author InformationCorrespondence address: Tel.: +61 3 9496 5442; fax: +61 3 9496 3572.

PII: S1574-6267(09)00251-1

doi:10.1016/j.aenj.2009.11.001


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