Transient Loss of Consciousness

Transient Loss of Consciousness (TLoC) is very common and affects up to half the population of the UK at some point in their lives. An episode of TLoC is often described as a ‘blackout’ or a ‘collapse’. This can be a dangerous and disabling condition, especially if there is little or no warning.

Causes of TLoC

Cardiovascular disorders (the most common cause), neurological conditions such as epilepsy, and psychogenic attacks can all result in TLoC.

Most unexplained blackouts are caused by syncope. Many people, including doctors, assume that blackouts are due to epileptic seizures, but much more commonly they are due to syncope – a type of blackout which is caused by a problem in the regulation of blood pressure or sometimes with the heart.

The similarity between a syncope ‘attack’ and epilepsy ‘seizure’ provides a diagnostic challenge even for specialists if trying to distinguish a case of syncope from one of epilepsy using visual cues alone.

Diagnosis and Treatment

The diagnosis of the underlying cause of TLoC is often inaccurate, inefficient and delayed. There is huge variation in the management of TLoC. People experiencing TLoC may come under the care of a range of clinicians, and the lack of a clear pathway may contribute to misdiagnosis and inappropriate treatment.

The New Malden Diagnostic Centre offers a TLoC Clinic for patients who have suffered from blackouts, fits, faints and/or funny turns.

The initial referral from a GP will be reviewed by both a Consultant Cardiologist and a Consultant Neurologist and the clinical decision will be made as to whether the patient follows the Cardiac Pathway or the Neurology Pathway. All of the diagnostics are completed at the Centre in a rapid, convenient and timely manner. If further specialist tests are required there are established routes to ensure further rapid assessment.

The Cardiac Pathway

The patient will have a full consultation with Dr. Elijah Behr followed by routine cardiac diagnostics such as an electro-cardiogram (ECG), an ultrasound of the heart (Echocardiogram) and a 24 hour ECG recording if required.

Additional tests such as week-long event recorders, Cardiac MRI, X-rays and blood-pressure monitoring may also be requested and followed up quickly.

Dr. Behr will then review all the results with the patient at a follow up clinic appointment. He will advise on further treatment and a care management plan to ensure the patient is clinically managed and where appropriate to ensure a speedy safe return to work.

The Neurology Pathway

The patient will have a consultation with Dr. Dominic Paviour followed by investigations which may include an electro-encephalogram (EEG) and an MRI scan of the brain and neck. Additional diagnostics may also be required according to the clinical presentation.

Dr. Paviour will then review the results with the patient at a follow up clinic appointment. He will advise on further treatment in order to ensure that the risk of further episodes is minimised and that where appropriate a speedy safe return to work and driving is possible.


If you feel you need advice and help managing your condition or you are yet to be diagnosed, please do not hesitate to get in touch by calling 020 8942 6555.