Observations on recurrent syncope and presyncope in 641 patients

Mathias, Christopher J.; Deguchi, Kazushi; Schatz, Irwin J.

doi:10.1016/s0140-6736(00)03642-4

Cited by 160 publications

(117 citation statements)

References 23 publications

Supporting

Mentioning

109

Contrasting

Unclassified

Order By: Relevance

“…In syncope clinics specialized in investigating elderly subjects with syncope there is a high frequency of carotid sinus syndrome (17-45 %) [39,40,59] while in a tertiary referral center specialized in autonomic disorders an exceptionally high frequency of chronic autonomic failure (4.8 %) was diagnosed [39].…”

Section: ■ Specialized Syncope Unitsmentioning

confidence: 99%

Epidemiology of reflex syncope

Colman

Nahm

Ganzeboom³

et al. 2004

Clin Auton Res

235

159

View full text Add to dashboard Cite

Section: ■ Specialized Syncope Unitsmentioning

confidence: 99%

Epidemiology of reflex syncope

Colman

Nahm

Ganzeboom³

et al. 2004

Clin Auton Res

235

159

View full text Add to dashboard Cite

“…5 In contrast, PPS is rarely mentioned in the literature on syncope, and the reported prevalence of PPS in those analyzed for presumed syncope is lower, ranging from 0% to 8%. [6][7][8] …”

mentioning

confidence: 99%

“…5 In contrast, PPS is rarely mentioned in the literature on syncope, and the reported prevalence of PPS in those analyzed for presumed syncope is lower, ranging from 0% to 8%. [6][7][8] Some authors suspect that it is insufficiently recognized. 9,10 At present, the gold standard for PPS is a demonstration of the absence of circulatory abnormalities causing cerebral hypoperfusion during an event.…”

mentioning

confidence: 99%

The semiology of tilt-induced psychogenic pseudosyncope

Tannemaat

Niekerk²,

Reijntjes³

et al. 2013

Neurology

View full text Add to dashboard Cite

Objectives: To provide a detailed semiology to aid the clinical recognition of psychogenic pseudosyncope (PPS), which concerns episodes of apparent transient loss of consciousness (TLOC) that mimic syncope. Methods:We analyzed all consecutive tilt-table tests from 2006 to 2012 showing proven PPS, i.e., apparent TLOC had occurred without EEG changes or a decrease in heart rate (HR) or blood pressure (BP). We analyzed baseline characteristics, video data, EEG, ECG, and continuous BP measurements on a 1-second time scale. Data were compared with those of 69 cases of tilt-induced vasovagal syncope (VVS).Results: Of 800 tilt-table tests, 43 (5.4%) resulted in PPS. The majority (74%) were women. The median duration of apparent TLOC was longer in PPS (44 seconds) than in VVS (20 seconds, p , 0.05). During the event, the eyes were closed in 97% in PPS but in only 7% in VVS (p , 0.0001). A sudden head drop or moving down the tilt table was more common in PPS than in VVS (p , 0.01), but jerking movements occurred more frequently in VVS (p , 0.0001). In PPS, both HR and BP increased before and during apparent TLOC (p , 0.0001).Conclusions: PPS is clinically distinct from VVS and can be diagnosed accurately with tilt-table testing and simultaneous EEG monitoring. Compared with VVS, eye closure during the event, long periods of apparent TLOC, and high HR and BP are highly specific for PPS. Improved understanding of the semiology of PPS as a clinical entity is vital to ensure accurate diagnosis. Neurology â 2013;81:752-758 GLOSSARY BP 5 blood pressure; DBP 5 diastolic blood pressure; HR 5 heart rate; PNES 5 psychogenic nonepileptic seizure; PPS 5 psychogenic pseudosyncope; SBP 5 systolic blood pressure; sMAP 5 smoothed mean arterial pressure; TLOC 5 transient loss of consciousness; VVS 5 vasovagal syncope.Transient loss of consciousness (TLOC) is the reason for approximately 3% of all emergency department visits. 1 The most common major causes of apparent TLOC are syncope, epileptic seizures, and psychogenic events. [2][3][4] The pathophysiology of psychogenic and somatic apparent TLOC is different, but they can be difficult to distinguish clinically.Psychogenic apparent TLOC bears various labels. When episodes involve pronounced movements, they resemble epilepsy and are frequently labeled psychogenic nonepileptic seizures (PNES). 5 Episodes without pronounced movements resemble syncope and are generally labeled psychogenic pseudosyncope (PPS). 3 PNES and PPS are probably manifestations of the same underlying psychiatric disorder, but their different presentation has important consequences for diagnosis. PNES is relatively well known, with a reported prevalence of up to 30% in patients in epilepsy clinics. 5 In contrast, PPS is rarely mentioned in the literature on syncope, and the reported prevalence of PPS in those analyzed for presumed syncope is lower, ranging from 0% to 8%. [6][7][8]

show abstract

“…Another study showed that the recurrent syncope is associated to fractures and soft tissue The positive tilt test identifi es individuals susceptible to the vasovagal syncope with a positivity rate between 40 and 60% and with a good diagnostic specifi city 9,10,11,13 . The diffi culty to predict recurrences has been the ground for several studies in the last few years [29][30][31][32][33] , aiming to identifying high-and low-risk patients.…”

Section: Discussionmentioning

confidence: 99%

Evolução clínica de pacientes com síncope neurocardiogênica (SNC) após suspensão da terapia específica

Bastos¹,

Scanavacca

Darrieux

et al. 2006

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

OBJECTIVETo evaluate the outcome of patients with NCS after interruption of pharmacological therapy and to investigate the possible clinical variables predicting recurrence. METHODSThirty-seven patients (age 31±16 years) with refractory recurrent NCS being 19 females where prospectively studied. All patients became asymptomatic and had a negative tilt table test (TT) after pharmacological therapy. The treatment was interrupted and one month later, a new TT with no medication was carried out. The probability free of symptoms recurrence was analyzed according to sex, age, number of syncope episodes previously to the treatment, clinical history time, treatment time, drug free from treatment time and TT result. RESULTSTwenty-two patients (59%) presented recurrence during a mean follow-up of 21±19.7 months. The variables related to greater recurrence were number of previous syncope (p=0.0248), positive TT after interruption of the therapy (p=0.0002) and female gender (p= 0.0131). CONCLUSIONSMost of the very symptomatic patients with NCS present recurrence after the suppression of a specifi c therapy. A TT carried out after treatment discontinuation can identify patients with higher risk of recurrence, specially in the fi rst year of follow-up.

show abstract

Observations on recurrent syncope and presyncope in 641 patients

Cited by 160 publications

References 23 publications

Epidemiology of reflex syncope

Epidemiology of reflex syncope

The semiology of tilt-induced psychogenic pseudosyncope

Evolução clínica de pacientes com síncope neurocardiogênica (SNC) após suspensão da terapia específica

Contact Info

Product

Resources

About