Outcome and consequences according to the type of transient loss of consciousness: 1-year follow-up study among primary health care patients.

UNLABELLED: The prognosis of transient loss of consciousness (LOC) was studied in a one-year follow-up survey. Included were adult patients referred by primary health care physicians for a non-acute specialist consultation during the 2-year period from 01.10.1999 to 30.9.2001. The main outcome measures were recurrence of LOCs during the follow-up, fear of recurrence, injuries, and employment. Altogether, 109 consecutive patients were followed and 39 (36%) suffered a recurrence during the one-year follow-up: 17 (30%) with syncope, 16 (43%) with seizure and six (38%) with uncertain type of LOC. The first ever seizure recurred in 5/9 (56%) during the first year, but only 1 of 17 (6%) first syncope attacks. There was no difference in the recurrence rate if the patient had had previous attacks prior to the index LOC. Injuries, mainly minor, were associated with LOCs in 56% of patients. The risk of injury was highest (83%) with alcohol-related seizures. The unemployment rate was especially high in the seizure group. Fear of recurrence was more common at the beginning than at the end of the follow-up.

CONCLUSIONS: Seizures recur relatively often, but also recurrent syncope needs more attention--both may cause fear and lead to injuries.