Predisposing Factors

Prodromal Manifestations

Postural Associations


Fatigue, hunger, a hot, humid environment

■ Peripheral neuropathies and disorders affecting the autonomic nervous system; drugs such as antihypertensives and vasodilators; prolonged bed rest

■ Bleeding from the GI tract or trauma, potent diuretics, vomiting, diarrhea, polyuria

Chronic bronchitis in a muscular man

Nocturia, usually in elderly or adult men

Restlessness, weakness, pallor, nausea, salivation, sweating, yawning

■ Lightheadedness and palpitations (tachycardia) on standing up

Often none except for cough

Often none

Usually occurs when standing, possibly when sitting

■ Occurs soon after the person stands up

■ Usually occurs soon after the person stands up

May occur in any position Standing to void

Prompt return of consciousness when lying down, but pallor, weakness, nausea, and slight confusion may persist for a time.

■ Prompt return to normal when lying down

■ Improvement on lying down

Prompt return to normal Prompt return to normal

Organic heart disease and old age decrease the tolerance to abnormal rhythms.

Cardiac disorders

Coronary artery disease Deep venous thrombosis

Often none

Often none. Onset is sudden.

Often none Often none

May occur in any position

Occurs with or after exercise

May occur in any position May occur in any position

Prompt return to normal unless brain damage has resulted

Usually a prompt return to normal



A predisposition to anxiety attacks and hyperventilation

Insulin therapy and a variety of metabolic disorders

Hysterical personality traits

Dyspnea, palpitations, chest discomfort, numbness and tingling of the hands and around the mouth lasting for several minutes. Consciousness is often maintained.

Sweating, tremor, palpitations, hunger; headache, confusion, abnormal behavior, coma. True syncope is uncommon.


May occur in any position

May occur in any position

A slump to the floor, often from a standing position without injury

Slow improvement as hyperventilation ceases

Variable, depending on severity and treatment

Variable, may be prolonged, often with fluctuating responsiveness

TABLE 16-7 ■ Seizure Disorders

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