Fainting causes loss of consciousness which is rapid but never so abrupt as in epilepsy. It is associated with pallor, and feeble, show or irregular pulse, syncope is due to temporary cerebral anoxia. It is commonly due to emotional causes but may be associated with disorders causing temporary insufficiency cardiac output or with cerebra vascular insufficiency. Prolonged syncope may cause an epileptic fit. There is a history of trauma and there may be signs of external injury. In concussion the face is pale, reflexes diminished or decent, and pupils equal dilated and sluggish, if there is compression due to intracranial hemorrhage the face may be flushed, breathing is torturous and the reflexes maybe asymmetrical. The pupil on the injured side first contracts and then dilates and the other pupil subsequently unconscious or incapable for some reason other than trauma may fall and injure his skull.