Management of vasovagal syncope

Ballantyne, Brennan; Letourneau-Shesaf, Sevan; Raj, Satish R.

doi:10.1016/j.autneu.2021.102904

Cited by 13 publications

(4 citation statements)

References 76 publications

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“…Given the transient sympathetic overactivation and vagal overcoming without orthostatic stress, the present case could be regarded as showing vasovagal syncope. Although its pathophysiology is still incompletely understood, vasovagal syncope is considered to be caused by an exaggerated sympathetic response that is followed by vagal overcoming [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, one retrospective study reported that de novo orthostatic hypotension was postoperatively recognized in 11.6% of patients with cervical spine surgery [ 2 ]. Considering that no definite therapies for vasovagal syncope are currently available [ 11 ], the therapeutic potential of decompression surgery for cervical autonomic dysfunction will be an important issue to be investigated.…”

Section: Discussionmentioning

confidence: 99%

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Latent Autonomic Dysfunction in a Chronic Cervical Spinal Injury

Fujioka¹

2023

Cureus

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Latent autonomic dysfunction has been identified in recent years among patients with chronic cervical lesions. This paper further illustrates a precautionary case of symptomatic manifestation with an elusive trigger. A 64-year-old male, who had shown excellent neurological recovery after decompression surgery for a cervical spinal injury (modified Frankel classification from C1 to D3), complained of recurrent syncope in the chronic phase. The cause remained unidentified for two years, but it was finally discovered that the syncope was induced by a transient sympathetic overactivation that was concurrent with mental strain and alcohol intake. Abstinence completely suppressed the episodes thereafter. The case suggests the possibility that patients with a history of cervical spinal injury, no matter how normal they appear, may have asymptomatic autonomic dysfunction. Additionally, identification of the trigger can be challenging due to its dynamic and protean nature. More emphasis should be paid to autonomic evaluation for chronic cervical spinal injuries.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Latent Autonomic Dysfunction in a Chronic Cervical Spinal Injury

Fujioka¹

2023

Cureus

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“…A Fig. 1 Key treatments for vasovagal syncope [1,5] and their impact on the vasovagal cascade [7] famous example is the report by Ladislaus von Bortkiewicz (1868-1931) who applied the Poisson distribution to evaluate the number of Prussian cavalrymen killed by horse kicks [16]. The figures perfectly fitted the expected numbers, thus demonstrating randomness and ruling out external factors like training year or cavalry corps.…”

mentioning

confidence: 97%

“…Most pharmacological interventions are supported by class II recommendations, with the best evidence for use of midodrine and fludrocortisone against recurrent VVS (Fig. 1) [1,5]. For a highly selective group of well-documented cases aged 40 years and older with dominant cardioinhibitory VVS, there is evidence for dualchamber cardiac pacing [1].…”

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confidence: 99%