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

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.

Keywords: Syncope, Vasovagal, Seizures, Case reports, Emergency nursing, Emergency medical services, Pacemaker, Artificial