A few seconds of normality, then collapse. Monday December 22, live from 19/20 from France 3 Limousin, journalist Fabrice Bidault suddenly fell from his chair, victim of an impressive malaise in front of the eyes of viewers.
“There’s a problem!”
The scene takes place after about ten minutes of broadcast. Facing his guest, Marion Fourtune, director of France Nature Environnement, the presenter begins to ask a question, then abruptly interrupts. He staggers, loses his balance and disappears from the camera’s view. Visibly worried, the guest exclaims: “There’s a problem!”alerting the technical teams, while the scene is still broadcast on the air. A few seconds later, the image is cut off.
After several minutes of interruption, another journalist, Annaïck Demars, takes over the newspaper. It is intended to be reassuring and evokes “a little discomfort”. “He is fine, I assure you, we will therefore continue this diary”she indicates, information confirmed at the end of the edition.
But what exactly does this word “discomfort” mean? And how do you know if a loss of consciousness should alert you immediately?
What the term “discomfort” actually means
In everyday language, the word is often used to describe a simple bout of fatigue or a moment of weakness. In medicine, however, discomfort covers very different realities. As Dr. Gérald Kierzek, emergency physician, explains:
“unwellness corresponds to a sudden feeling of unease, which can occur with or without loss of consciousness. Its severity varies enormously, ranging from a benign and transient episode to situations that can be life-threatening, such as a serious heart disorder or an epileptic attack.”
Concretely, discomfort can manifest itself by:
- Dizziness;
- A feeling of lightheadedness or sudden weakness;
- Sweating, paleness;
- Blurred vision, nausea;
- Sometimes a brief loss of consciousness, called
syncope.
Vagal discomfort, the most common scenario
In the majority of situations observed, particularly in people without known pathology, the discomfort is called “vagal”. “This type of syncope is linked to a transient drop in blood pressure and heart rate, causing insufficient blood flow to the brain. It is impressive, sometimes spectacular, but most often benign. specifies our expert.
It typically occurs in well-identified contexts: prolonged standing, excessive heat, confined atmosphere, significant fatigue or dehydration. Intense emotion, sudden stress, pain or even the sight of blood can also be the trigger.
This is why this type of discomfort can occur in young and apparently healthy people.
Often evocative warning signs
Vagal discomfort is rarely completely sudden. In most cases, it is preceded by warning signs that the person can recognize: a feeling of sudden weakness, the impression that “the head is emptying”, dizziness or the appearance of a black veil before the eyes. This is frequently accompanied by hot flashes followed by cold sweats, marked pallor and sometimes nausea or ringing in the ears.
These signals should prompt people to sit or lie down quickly, because loss of consciousness often occurs when the person remains standing despite these symptoms.
“But when the discomfort is vagal, the loss of consciousness is brief, or even absent. The person falls due to muscular relaxation, but quickly regains their senses as soon as they lie down. In a few tens of seconds or a few minutes, consciousness is complete, speech coherent, without prolonged confusion or neurological deficit.”
However, great fatigue persists, sometimes a need to lie down and drink. The fact that the person can explain what they felt and remember the episode is reassuring.
When discomfort becomes a warning signal
Conversely, certain signs should immediately raise awareness of a serious situation.
Dr. Gérald Kierzek emphasizes the importance of the duration and quality of recovery.
- “A prolonged loss of consciousnessa person who is difficult to wake up or remains confused several minutes after the episode should never be trivialized”;
- Of the abnormal respiratory signs — very slow, very fast, noisy or difficult breathing — are also a major warning, as is a bluish discoloration of the lips or fingers;
- On the cardiovascular level, a
chest painintense palpitations, extreme pallor or profuse sweating may suggest a serious heart problem; - Finally, the appearance of neurological signssuch as paralysis on one side of the body, facial asymmetry, speech problems or a sudden and unusual headache, should raise suspicion of a stroke or other neurological emergency.
“Even in the absence of spectacular signs, certain contexts should encourage extreme caution. Discomfort in a person with a history of heart attack, heart rhythm disturbances, heart failure or epilepsy is always more worrying. The same goes for people on anticoagulants, in pregnant women or when several discomforts occur over a short period.”
In these situations, the apparent improvement should not be wrongly reassuring: calling 15 or 112 is essential.
Malaise or epileptic seizure: important differences
Finally, an epileptic seizure can sometimes be confused with discomfort, but certain elements allow the distinction to be made.
- “The attack often begins suddenly, without warning signs, with a sudden fall and immediate loss of consciousness. It is classically accompanied by a phase of muscular stiffness, followed by generalized jerks, called convulsions”;
- The gaze is fixed, breathing may become noisy and irregular, and signs such as tongue biting or loss of urine may occur;
- After the attack, the person generally remains confused, disoriented and very drowsy for several minutes, sometimes longer: this is the so-called post-ictal phase.
How to react to discomfort?
When faced with a person who is feeling unwell, the first measure is to lay them on their back and, if possible, elevate their legs to encourage the return of blood to the brain. You need to loosen your clothes, ventilate the room and reassure the person. Until the discomfort has completely passed, it is important not to pick it up too quickly.
“In the event of loss of consciousness with retained breathing, positioning in a lateral safety position is essential. And as soon as there is doubt about the seriousness of the situation, the call for help must be immediate.”