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Blackout Checklist

Checklist: Essentials

There are two major reasons why people experience episodes of unconsciousness.

  • The first is a sudden lack of blood supply to the brain. Commonly called a blackout, the medical term is syncope. Syncope is caused by a problem with the heart or by a problem in the regulation of blood pressure.
  • The second is an electrical ‘short-circuiting’ in the brain. This is called epilepsy and the attacks are usually called seizures.
  • Doctors use the term “Transient Loss Of Consciousness” or T-LOC when describing these events.
  • Up to 50% of the population will lose consciousness because of syncope (blackouts) at some point in their life. Epilepsy affects less than 1% of the population. Either condition can affect people of all ages.
  • Many syncope attacks are mistaken for epilepsy. This mistake is because syncope may appear  like an epileptic seizure, with random jerking of the limbs and even incontinence. It can be difficult, even for experts, to tell the causes apart. It is essential to provide a detailed history, and if possible a video of your unconscious experience.
  • Every patient who experiences T-LOC should describe everything they can recollect about their symptoms to a doctor. The doctor will also try to obtain a description from an eye-witness.
  • Diagnosis of epilepsy is made by a neurologist. It is based primarily on a patient’s history.
  • Every patient presented with an unexplained blackout should be given a 12-lead ECG (heart rhythm check). If there is uncertainty about diagnosis the ECG should be reviewed by a heart rhythm specialist.
  • When attacks are frequent, heart irregularities can be captured by a portable ECG device – which can typically be carried for up to two weeks.
  • When attacks are less frequent, they might be captured with an insertable loop recorder (ILR) • which can constantly monitor the heart for a period of up to 18 months.
  • Over 70% of sufferers of syncope endure migraine headaches, depression or anxiety because of their attacks, and a similar number alter their daily activities to avoid the risk of blacking out in embarrassing or dangerous circumstances.
  • After most syncope (blackouts), reassurance and education by a doctor or highly trained nurse is all that is needed; however, if attacks continue or become more frequent, consultation with a specialist is needed.