Sandbox:Sahar

Syncope, must be differentiated from other diseases that may cause, altered mental status, motor and or somatosensory deficits. The table below, summarizes the neurologic differential diagnosis for syncope:

Diseases	History	Symptoms				Physical Examination					Diagnostic tests			Other Findings
Diseases	History	Headache	↓ LOC	Motor weakness	Abnormal sensory	Motor Deficit	Sensory deficit	Speech difficulty	Gait abnormality	Cranial nerves	CT/MRI	CSF	Gold standard test	Other Findings
Subdural hemorrhage^[1]^[2]	Trauma Fall	+	+	+	+	+	–	–	–	+	+	Xanthochromia	CT scan without contrast	Confusion Dizziness Nausea and vomiting
Neurosyphilis	Sexually transmitted disease	+	–	+	+	+	+	–	+	–	+	↑ Leukocytes and protein	Specific: CSF VDRL Sensitive: CSF FTA-Ab	Blindness Confusion Depression Abnormal gait
Hypertensive encephalopathy	Hypertension	+	+	–	–	–	–	+	+	–	+	NA	Clinical assesment	Delirium Cortical blindness Cerebral edema Seizure
Wernicke’s encephalopathy	History of alcohal abuse	–	+	–	–	–	+	+	+	+	–	NA	Clinical assesment and lab findings	Ophthalmoplegia Confusion
Drug toxicity	Medication history of Lithium Sedatives Phenytoin Carbamazepine	–	+	–	+	+	+	–	+	–	–	NA	Drug screen test	Confusion
Metabolic disturbances (electrolyte imbalance, hypoglycemia)	–	–	+	+	+	+	+	–	–	+	–	Hypoglycemia, hyponatremia, hypernatremia, hypokalemia, and hyperkalemia	Depends on the cause	Confusion Seizure Palpitation Sweating Dizziness Hypoglycemia
Meningitis or encephalitis	History of fever and malaise	+	–	–	–	–	+	+	–	–	–	↑ Leukocytes, ↑ protein, ↓ glucose	CSF analysis	Fever Neck rigidity Confusion
Seizure	Previous history of seizures	+	+	–	–	+	+	–	–	+	–	Mass lesion	Clinical assesment and EEG	Confusion Apathy Irritability