Clinical Features

Syncope, the momentary loss of consciousness, results from transient global ischemia of a few seconds duration.

Hypoxic and ischemic encephalopathy results from a mild to moderate continuous hypoxia that produces a variety of symptoms, including headaches, confusion, memory and cognitive impairment, seizures, myoclonus, and motor and sensory deficits. Severe hypoxia, when it lasts 10 minutes or more, produces diffuse and profound cerebral damage manifested by alterations of consciousness ranging from lethargy to deep coma, seizures, myoclonic jerks, changes of muscle tone, and pathologic reflexes.

Late sequelae comprise a broad spectrum of neurologic and mental symptoms. At one extreme is full recovery and, at the other, irreversible coma, persistent vegetative state, or dementia (Figs. 3.7, 3.8 and 3.9; Tables 3.1 and 3.2). A variety of temporary or permanent symptoms may occur between these extremes: seizures, action myoclonus, parkinsonian features; cer-ebellar ataxia; visual, motor, and sensory deficits; variable degrees of cognitive and memory impairment; affective disorders; and behavioral changes.

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