Syncope and electroencephalography

Sir,van Dijk and colleagues have made an impressive scientific analysis of the relation between the clinical features during head-up-tilt induced syncope in adults and the simultaneous EEG findings (van Dijk et al. , 2014). In particular, these authors have drawn attention to the semiology associated with the ‘classical’ slow-flat-slow EEG pattern and with simple EEG slowing without EEG flattening. I would like to add some observations to their excellent study, based on personal experience (Stephenson, 1990) and perusal of the literature.If syncope is sufficiently severe the slow-flat-slow EEG appearance seems to be independent of age—in that it is also observed in young children—and is seen in all types of syncope, however induced. However, the exact clinical semiology seems to vary with different methods of syncope generation. For example, in Gastaut and Fischer-Williams’s (1957) predominantly …