van Dijk J Gert, Harms Mark P M, de Lange Frederik J, Rutten Joost H W, Thijs Roland D, van der Velde Nathalie
LUMC, afd. Neurologie, Leiden.
Contact: J. Gert van Dijk (
Ned Tijdschr Geneeskd. 2022 Mar 9;166:D6615.
Although transient loss of consciousness (TLOC) is a common problem, hospital care for patients with TLOC is characterised by high rates of no diagnosis and misdiagnosis, accompanied by unnecessary hospital admissions and tests. We attribute these problems to increasing specialisation as well as to a blind spot for vasovagal syncope, a condition not claimed by any specialty. We suggest that all doctors seeing patients with TLOC, both in primary and secondary care, should be familiar with the presentations of the relatively harmless vasovagal syncope and the alarm symptoms of potentially life-threatening cardiac syncope. In this article we present some practical pointers to recognise these conditions and answer some frequently-asked questions regarding the diagnosis and treatment of TLOC.
尽管短暂性意识丧失(TLOC)是一个常见问题,但TLOC患者的住院治疗存在诊断率低和误诊率高的特点,同时伴有不必要的住院和检查。我们将这些问题归因于专业化程度的提高以及血管迷走性晕厥这一未被任何专科认领的病症所形成的盲点。我们建议,无论是在初级医疗还是二级医疗中,所有诊治TLOC患者的医生都应熟悉相对无害的血管迷走性晕厥的表现以及潜在危及生命的心脏性晕厥的警示症状。在本文中,我们给出了一些识别这些病症的实用要点,并回答了一些关于TLOC诊断和治疗的常见问题。