Syncope as a first sign of seizure disorder

We studied the long-term follow-up of patients with the diagnosis of "synco pe of unknown origin," and their progression to epilepsy to gain a better u nderstanding of the relationship between syncope and epilepsy, and to deter mine whether findings of the first syncopal attack have prognostic signific ance in relationship to the onset of epilepsy or not. Eighteen patients vii th the diagnosis of syncope of unknown origin were evaluated for the possib ility of becoming epileptic during a 4-year period, and four patients showe d characteristic seizure disorder. There were no clinical or laboratory fea tures that differentiated them from the nonepileptic group, except that the y were all girls. The interval between the first syncopal attack and the ty pical epileptic seizure ranged between 7 and 19 months. Syncope of unknown origin could be the first sign of an epileptic disorder, especially in girl s. Long-term follow-up extending up to 1 year is necessary to disclose the risk of becoming epileptic.