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On Sabbatical

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TITLE: Electroencephalography in syncope.
AUTHOR: Brenner RP
AUTHOR AFFILIATION: University of Pittsburgh, Pennsylvania, USA.
SOURCE: J Clin Neurophysiol 1997 May;14(3):197-209
NLM CIT. ID: 97386310
ABSTRACT: Electroencephalographic (EEG) findings in syncope are reviewed. There are four major categories of syncope: neurally mediated (neurocardiogenic), neurologic, decreased cardiac output, and orthostatic hypotension. However, regardless of cause, whether the syncope is due to a vasovagal effect, a cardiac arrhythmia, an epileptic seizure, or hypotension, EEG findings are similar and reflect cerebral hypoperfusion. Initially there may be a slowing of background rhythms. This is followed by high amplitude delta activity, maximal anteriorly. If the hypoperfusion persists there is subsequent flattening of the EEG. The EEG returns to normal in the reverse sequence. In cases with severe and prolonged ischemia, convulsive syncope may occur at the time of the EEG flattening. Although not an epileptic phenomena, clinically this is often mistaken for epilepsy. Conversely, epileptic disorders, such as the ictal bradycardia syndrome, may occasionally mimic syncope. Therefore, in patients in whom EEGs are performed for the evaluation of an episode of loss of consciousness, simultaneous ECG should be used.
MAIN MESH SUBJECTS: *Electroencephalography
Syncope/*DIAGNOSIS/PHYSIOPATHOLOGY
ADDITIONAL MESH SUBJECTS: Adult
Aged
Autonomic Nervous System Diseases/COMPLICATIONS
Cardiac Output, Low/COMPLICATIONS
Child
Female
Human
Male
Middle Age
Peripheral Nervous System Diseases/COMPLICATIONS
Seizures/DIAGNOSIS/ETIOLOGY
Syncope, Vasovagal/DIAGNOSIS/ETIOLOGY
PUBLICATION TYPES: JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
LANGUAGE: Eng

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On Sabbatical!

When my office lease expired at the end of 2004, I decided to turn it into a "sabbatical" from my private practice. Many years ago, in my grandfather's 89th year of life, he told me, "John, it is important to smell the roses while you can still smell them." His life gave living a very good reputation. It is also true that the pursuit of that philosophy required my grandfather to to re-open his assay office/ore market in Wickenburg, Arizona as a 75-year-old because he had run a little short of retirement money. Thus, if blessed with his luck and health, I'll be back.. --jjh

Copyright 1998-2007  John J. Herr, Ph.D.                                   Please send comments to jjherr@clinicalpsychologist.com