Irregular rhythm?

Tags: syncope
For several months my daughter was having symptoms of either syncope or "atypical" migraines.  She has had every test imaginable including viewing the heart for a hole.  All test results have been negative.  She is an RN who was working nights and the doctor felt sleep deprivation could be a cause and he took her off bc pills until all test results were in.  During the time she was off bc she did not have an episode. She began a 3-11 shift that was a much better sleeping schedule.  She went back on bc after all test resulst were in and she had an episode this week, where she was "out" for over an hour.  She was found at the bottom of a short stair case; she had no memory of the event.  She said that she felt "odd" all day, but did not complain of pain.  She went to the ER where, five hours later, it was determined to be syncope.  I am worried that these episodes could occur while driving or working.  How can the cause of these episodes be determined.

[Cleveland Clinic]

Syncope is a symptom, not a diagnosis: it means that she lost consciousness. It sounds as if this may be life threatening so usually these are evaluated in the inpatient setting. Syncope without a prodrome, that is warning, is usually malignant and can be caused by structural heart abnormalities, arrhythmias, rarely congenital abnormalities. It can also e caused by neurological disorders such as seizures, which I think are the most likely cause of syncope in her case.