Abstract

Consciousness is a complex physiologic state that is difficult to account for scientifically but is nonetheless widely understood in intuitive terms. From an operational perspective, the loss of consciousness (i.e., unconsciousness) that most physicians concern themselves with (e.g., in the context of syncope and related disorders) relates to loss of alertness. As discussed by van Dijk et al.,1 this concept of unconsciousness is restricted to a disturbance of the “arousal” part of consciousness that resides either in the brainstem or in the integrity of a very large part of the cerebral cortex. Loss of consciousness in this context is always associated with inability to control posture and consequently the affected individual falls or slumps over.

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