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Synkope und epileptischer Anfall

  • Schwerpunkt: Internistische Notfallmedizin
  • Published:
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Zusammenfassung

Die Synkope ist eines der häufigsten Symptome, welche zur stationären Einweisung führen. Dabei können verschiedenste Grunderkrankungen Ursache der Synkope sein. Entscheidend ist das Erkennen von zugrundliegenden strukturellen Herzerkrankungen und Rhythmusstörungen, da diese mit einer deutlich erhöhten Letalität einhergehen. Entscheidende Hinweise auf die Genese der Synkope gibt die sorgfältige Anamnese; ergänzende Untersuchungen sollten nur gezielt eingesetzt werden. Bei Nachweis einer strukturellen Herzerkrankung ist die Therapie der Grunderkrankung einzuleiten, bei Nachweis einer rhythmogen Synkopen kann die Therapie mit Schrittmacher, implantierbarem Kardioverter-Defibrillator oder Antiarrhythmika indiziert sein. Bei den häufigen neurogenen und orthostatischen Synkopen führt in erster Linie der Einsatz tonisierender körperlicher Übungen zum Erfolg. Neben Synkopen ist bei temporärer Bewusstseinsstörung auch an einen epileptischen Anfall zu denken. Bei der Differenzierung ist dabei vor allem die Fremdanamnese zum Verlauf der Synkope von Bedeutung.

Abstract

Syncope is one of the most common symptoms leading to hospital admission. Thereby syncope can be induced by several diseases. It is crucial to detect underlying structural heart disease or high grade arrhythmias, as these are associated with an increased mortality. The careful history and physical examination can often give sufficient evidence to evaluate the origin of syncope. Additional examinations should only be applied selectively. In patients with structural heart disease the specific treatment should be initiated, in patients with cardiac arrhythmias the implantation of a pacemaker or ICD might be indicated. The most common neurally-mediated and orthostatic syncopes can often be treated successfully by physical training. Beside syncope epilepsy might be responsible for a transient loss of consciousness. Again careful history taking helps to differentiate between these two entities.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik I, Klinikum Großhadern der Ludwig-Maximilians-Universität München

    A. Becker, C. Reithmann & G. Steinbeck

  2. Neurologische Klinik, Klinikum Großhadern der Ludwig-Maximilians-Universität München

    S. Noachtar & T. Brandt

  3. Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, München

    A. Becker

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  1. A. Becker
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  2. S. Noachtar
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  5. G. Steinbeck
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Correspondence to A. Becker.

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Becker, A., Noachtar, S., Reithmann, C. et al. Synkope und epileptischer Anfall. Internist 46, 994–1005 (2005). https://doi.org/10.1007/s00108-005-1475-9

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  • DOI: https://doi.org/10.1007/s00108-005-1475-9

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