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Life and death diagnosis
  1. David Chadwick1,
  2. Paddy Jelen2,
  3. Solomon Almond3
  1. 1Emeritus Professor of Neurology, Walton Centre, Liverpool, UK
  2. 2Nurse Practitioner, The Deepings Practice, Market Deeping, Peterborough, UK
  3. 3Consultant in Acute Medicine, Royal Liverpool Hospital, Liverpool, UK
  1. Correspondence to D Chadwick, Walton Centre, Lower Lane, Liverpool L9 7LJ, UK; d.w.chadwick{at}


The differential diagnosis of episodes of transient loss of consciousness can be straightforward but can also present some of the greatest diagnostic difficulties. In most circumstances, when there is uncertainty, usually when there have been only one or a few poorly observed events, it may be reasonable to admit to that uncertainty and await any further events to clarify the diagnosis. We have reason to know from bitter experience that this is not always the case and that more rigorous consideration of investigation may be justified rather than allowing the passage of time to clarify the diagnosis.

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  • PJ is East Midlands representative for Cardiac Risk in the Young

  • Provenance and peer review Commissioned; not externally peer reviewed.

  • Patient consent Obtained.

  • Competing interests None.

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