Álsyncope és álgörcsroham@@@Pseudosyncope and pseudoseizure

A syncope gyakori korkep, mely jelentős terheket ro az egeszsegugyre. Bar diagnosztikus eszkozeink fejlődnek, az esetek egy kis hanyadaban az eszmeletvesztes pontos oka az alapos kivizsgalas ellenere is rejtve marad. Az ismeretlen eredetű syncopek csoportjaba tartozik a pszichogen alsyncope, mely – szemben a valodi syncopeval – nem jar az agyi keringes atmeneti zavaraval. Az alsyncope valojaban a konverzios betegseg egyik megnyilvanulasa, es mint ilyen, szamos jellegzetessegeben osztozik az algorcsrohammal. Az utobbira ugyancsak jellemző, hogy a rohamok alatt hianyoznak a gorcstevekenyseg jellegzetes neurologiai es EEG-manifesztacioi. A ket megjelenesi forma esetenkent ugyanazon betegben valtakozva lephet fel. Kozlemenyunkben egy alsyncopekat es algorcsrohamokat egyarant produkalo beteg tortenetet mutatjuk be. Az eset kapcsan attekintjuk az alsyncope irodalmat, es felhivjuk a figyelmet az interdiszciplinaris diagnosztikus megkozelites szerepere. Syncope is a frequent complaint which imposes a considerable burden on the health care systems. Although our diagnostic tools have improved during the last decades, the exact cause of syncope still remains unknown in a small fraction of cases. In the heterogenous group of „syncope with unknown origin” there are a few cases of pseudosyncope. Unlike the true episodes of syncope, the episodes of pseudosyncope are not associated with compromized cerebral circulation. The pseudosyncope in reality is a manifestation of conversion disorder, and as such shares many features with pseudoseizure. The latter is also characterized by the lack of typical neurological and EEG manifestations at the time of attacks. We present a case of a 57-year-old female with a 30 year history of attacks corresponding either to pseudosyncope or pseudoseizure. A brief overview of literature of pseudosyncope is also given, and the importance of an interdisciplinary diagnostic approach is emphasized.