Adams-Stokes syndrome is a disorder characterized by a sudden and transient loss of consciousness, due to an abrupt episode of change in heart rhythm. The patient may experience a sudden episode of bradycardia or absence of pulse and syncope that may be followed by epileptic seizures. Adams-Stokes syndrome may be caused by a variety of underlying cardiac pathologies and requires a comprehensive cardiovascular examination in order to be diagnosed with accuracy.
An Adams-Stokes episode initially manifests with significant pallor, followed by impairment of consciousness that ranges from a fainting tendency to a complete loss of consciousness. The aforementioned episode is elicited by a sudden change in the heart rhythm, that may involve tachyarrhythmia or bradyarrhythmia.
Epileptic seizures without an aura may or may not accompany the Adams-Stokes related episode; their onset is usually acute and unexpected, as is their resolution. Patients tend to resume their prior activity without realizing that epileptic activity has taken place. After the individual has fully regained consciousness, flushing is observed, that can be attributed to reactive hyperemia. The episodes described above may develop regardless of the posture of the patient and may be experienced up to multiple times each day.
Approximately 10% to 20% of all Adams-Stokes syndrome episodes are induced by third-degree sinoatrial block paroxysms  . A variety of supraventricular arrhythmias can also be held accountable for the syncopic events observed in Adams-Stokes syndrome and can even co-exist in the same patient   . The presence of a well-defined dysrhythmic condition leads to additional symptoms that can aid in the diagnosis of the underlying cause; symptoms most commonly associated with dysrhythmias that can lead to an Adams-Stokes episode include fatigue, palpitations, and discomfort.
Any patient presenting with a syncopic event is required to undergo multiple tests and examinations in order to detect the precise cause of the loss of consciousness. A fainting spell raises suspicion towards Adams-Stokes syndrome, when the patient reports a sudden-onset fainting tendency or loss of consciousness, following otherwise unexplained pallor. After the episode is resolved, the patient typically reports flushing.
For the physician to establish an accurate diagnosis of Adams-Stokes syndrome, many of the following tests should be carried out and evaluated:
A potential Adams-Stokes episode, complicated by convulsions should prompt neurological evaluation as well.