Episodes Last about 1.5 Hours & Fainting Spells & Interictal Downbeat Nystagmus: Causes & Reasons

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Patient File

Sex unknown, Age unknown

Reported Symptoms

Episodes Last about 1.5 Hours, Fainting Spells, Interictal Downbeat Nystagmus,

Negated

None

Unsure

None

Possible Causes

Episodic Ataxia

According to Baloh and others (1997), EA2 is characterized by a progressive ataxia with interictal rebound nystagmus evoked by gaze, as well as downbeating nystagmus. [dizziness-and-balance.com]

EPILEPSY IMITATORS OVERVIEW SYNCOPE AND ANOXIC SEIZURES Vasovagal syncope Reflex anoxic seizures Breath-holding attacks Hyperventilation syncope Compulsive valsalva Neurological [epilepsydiagnosis.org]

Initial examination disclosed a central type of positional nystagmus (conjugate downbeat nystagmus that did not fatigue with repeated positioning). [jnnp.bmj.com]

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Acute Cerebellar Ataxia

; EA2 with interictal nystagmus, is long-lasting (hours) associated with attacks of vertigo, diffuse weakness, slurred speech, dystonia, seizures, truncal and limb ataxia [neuroweb.us]

Progressive autonomic failure (PAF) differs from MSA by the slower onset and progression, absence of associated neurological features, no REM sleep abnormalities, no syncope [neuroweb.us]

[…] and downbeat nystagmus, often associated with nausea, vomiting and headache (migraine, often hemiplegic migraine). [neuroweb.us]

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Insect Bite

(passing out) or near-syncope Confusion Hives, especially rapidly occurring large hives Stomach cramps, Nausea and vomiting If the person who has been bitten or stung carries [medicinenet.com]

Numerous stings can result in toxicity with possible symptoms including nausea, vomiting, headache, fever, syncope, seizure, rhabdomyolysis and renal failure. 14 Bee and wasp [podiatrytoday.com]

[…] signs and symptoms indicate the person should receive immediate (emergency) treatment: Shortness of breath Swelling of lips, tongue, or throat Rapid heartbeat Dizziness, syncope [medicinenet.com]

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Hypersensitivity

The syncopal episodes completely resolved with periodic occurrence of hypertension. [ncbi.nlm.nih.gov]

The arterial baroreflex is crucial for short-term blood pressure control - abnormal baroreflex function predisposes to syncope and falling. [ncbi.nlm.nih.gov]

[…] the differential diagnosis of presyncope and syncope. [5] CSH, orthostatic hypotension, and vasovagal syncope are common conditions that are likely to coexist in patients [emedicine.medscape.com]

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Anemia

Cardiovascular symptoms include syncope, dyspnea, orthopnea, palpitations, and angina. [web.archive.org]

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Hyperventilation

One must rely solely on a very careful history and elicit time of onset and place to get a possible lead if it is a patient complaining of having had “fainting spells,” “heart [aafp.org]

We present the case of a patient who presented with recurrent syncope. [ncbi.nlm.nih.gov]

In this case report we describe a trial of experimentally induced syncope in a healthy young volunteer that produced abnormal periods of hyperventilation (V(A) 57 L/min) and [ncbi.nlm.nih.gov]

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Hypertension

However, they are more likely to be susceptible to serious harm from higher rates of syncope and hypotension, which were seen in some trials. [doi.org]

However, treatment-related adverse events increased in the more intensively treated patients, with more frequent hypotension, syncopal episodes, acute kidney injury and electrolyte [dx.doi.org]

Low-quality evidence showed an increased risk for syncope associated with treatment to lower BP targets (achieved SBP range, 121.5 to 143 mm Hg) (RR, 1.52 [CI, 1.22 to 2.07 [doi.org]

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Essential Hypertension

For patients with severe side effects like symptomatic hyperkalemia or hyponatremia, syncope and acute kidney injury (AKI), treatment needs to be discontinued, and in-patient [ncbi.nlm.nih.gov]

However, the rate of adverse events of hypotension, syncope, acute kidney injury, and electrolyte disorders, but not injurious falls, was higher in the intensive treatment [renalandurologynews.com]

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Hypoglycemia

We present a case of an 85-year-old man who presented to the endocrinology clinic with symptoms of "fainting spells after large meals." [ncbi.nlm.nih.gov]

A 64 year-old African female was brought to the emergency room with a 1-month history of recurrent syncope, weight loss, and abdominal bloating. [ncbi.nlm.nih.gov]

Insomnia Mental Confusion Nervousness Faintness Depression Heart Palpitations Family history of low blood sugar or diabetes Exhaustion Low libido (sex drive) Inability to [disabled-world.com]

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Panic Attacks

"Hyperventilation-Induced Syncope: No Need to Panic." Clinical Medicine and Research 1.2 (2003): 137-139. Friedlander, A.H., S.R. Marder, E.C. Sung, and J.S. Child. [medicinenet.com]

Mitral Valve Stenosis Myocardial Infarction Myocardial Ischemia Myocarditis Pericarditis Shortness Of Breath Sports Cardiology Sudden Cardiac Death (Sudden Cardiac Arrest) Syncope [my.clevelandclinic.org]

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Orthostatic Hypotension

This is different from a syncope caused by cardiac problems because there are known triggers for the fainting spell (standing, heat, emotion ) and identifiable prodromal symptoms [en.wikipedia.org]

Water ingestion - -drinking 16 oz of water over 5 minutes can prevent a fainting spell (Lu et al, 2003).. [dizziness-and-balance.com]

Pacemaker therapy for prevention of syncope in patients with recurrent severe vasovagal syncope. Jama 2003:289:2224-2229 Freeman R, Young J, Landsberg L, Lipsitz L. [tchain.com]

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Familial Episodic Pain Syndrome Type 1

Most patients also show various interictal nystagmus, such as gaze-evoked nystagmus (GEN), rebound nystagmus, or primary position downbeat nystagmus. [e-jmd.org]

Neurocardiogenic syncope Neurocardiogenic syncope (NCS) is the most common dysautonomia. It affects tens of millions of people worldwide. [medicalnewstoday.com]

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Hay Fever

The humor and impact of a play like Hay Fever comes partly from the rapid staccato dialogue, the type of syncopated speedy delivery of lines that would later become the hallmark [encyclopedia.com]

The Bear Comes Home, which received the PEN/Faulkner Award for fiction. 1925: The Charleston—a jittery, kinetic dance performed with a partner to music with a staccato, syncopated [encyclopedia.com]

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Alcohol Abuse

We report a fatal case of fungal (candidal) endocarditis of the tricuspid valve with clinico-pathologically interesting findings following and associated with candidal pneumonia during long-term central venous catheterization (CVC) for intravenous therapy and long-term treatment with antibiotics for bacterial and[…] [ncbi.nlm.nih.gov]

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Food Poisoning

In October 1988, food poisoning due to the freshwater puffer Tetraodon fangi occurred. Six out of eight people who consumed spicy soup (Tom Yam) of puffer developed clinical signs of tetrodotoxin intoxication. The incubation period varied from 30 min to 3 hr and there were no deaths. Puffers were collected one[…] [ncbi.nlm.nih.gov]

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Food Allergy

Reported food-related symptoms of patients may sometimes be misleading. A correct delineation of food-induced symptoms is often difficult and various differential diagnoses have to be considered. We report on two cases of food-induced, predominantly respiratory symptoms (in one case life-threatening) in children[…] [ncbi.nlm.nih.gov]

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Chronic Alcoholism

It is associated with an increased incidence of cardiac arrhythmia, hypertension, stroke, acute hepatitis, cirrhosis, gastritis, pancreatitis, syncope, amnesia and personality [medical-dictionary.thefreedictionary.com]

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Cardiac Arrhythmia

Diagnosis Your doctor will ask about your family history of coronary artery disease, cardiac arrhythmias, fainting spells or sudden death from heart problems. [2minutemedicine.com]

When To Call a Professional Call your doctor if you have any symptoms of a cardiac arrhythmia, including palpitations, dizziness, fainting spells, fatigue, shortness of breath [2minutemedicine.com]

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Streptococcal Infection

We report the case of a young man who presented with a severe acute akinetic-rigid disorder 2 weeks after complete recovery from an episode of pharyngitis. Magnetic resonance imaging scan abnormalities strikingly localized to the basal ganglia were accompanied by serological evidence of recent streptococcal[…] [ncbi.nlm.nih.gov]

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Muscle Strain

A left gastrocnemius strain was sustained by an elite cricket batsman while he was taking off to run. The exact moment of injury, captured by a camera in the middle stump, appears to correspond to the sudden appearance of a deficit in the gastrocnemius muscle, seen through the player's trousers. The strain[…] [ncbi.nlm.nih.gov]

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Vasovagal Syncope

Sources: Mayo Clinic About.com Health Topics: Epilepsy, Seizures, Fainting, Syncope, Vasovagal Syncope, Fainting Spells, Careers in Neurodiagnostics [rscdiagnosticservices.com]

A blood test might also be done to look for conditions of the blood such as anemia which might be a cause to the fainting spell or dizziness you have. [gazettereview.com]

Avoid fainting spells by recognising the symptoms before it happens. [mountelizabeth.com.sg]

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Peripheral Neuropathy

[…] variety of autonomic symptoms may be present, although certainly the most dramatic and incapacitating is orthostatic hypotension, which causes postural light- headedness, syncope [clevelandclinicmeded.com]

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Motion Sickness

RESULTS: The MD group showed significantly elevated MSS, more headache and migraine, increased VDD, higher SWID4 scores, and increased syncope. [ncbi.nlm.nih.gov]

[…] prolonged vomiting can lead to dehydration and electrolyte abnormalities, which if left untreated, may lead to more serious problems such as low blood pressure ( hypotension ), syncope [emedicinehealth.com]

The authors conducted an online survey that posed diagnostic and disease questions before addressing frequency of headaches, migraines, visual display dizziness (VDD), syncope [ncbi.nlm.nih.gov]

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Hyponatremia

Patients with hyponatremia often present with changes in mental status or with syncope. [consultant360.com]

"Syncope: risk stratification and clinical decision making". Emergency Medicine Practice. 16 (4): 1–22, quiz 22–3. PMID 25105200. [en.wikipedia.org]

What additional questions might you ask to elucidate the cause of her syncopal episodes? 2. What additional investigation would you find helpful? 2. [intechopen.com]

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Supraventricular Tachycardia

spells Sometimes, there are no symptoms. [ucsfhealth.org]

Symptoms include fainting spells, shortness of breath, chest pain and tightness in the throat. [advocatehealth.com]

[…] fast or too slow can cause: Lightheadedness or dizziness Palpitations (skipping, fluttering or pounding in the chest) Fatigue Chest pressure or pain Shortness of breath Fainting [ucsfhealth.org]

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Syncope

If fainting spells occur often without a triggering event, syncope may be a sign of an underlying heart disease. [ninds.nih.gov]

For most people, syncope occurs once or twice in a lifetime; for others, various medical conditions may lead to numerous fainting spells throughout their life. [brighamandwomens.org]

General Information Syncope, often referred to as a fainting spell, is the abrupt and brief loss of consciousness due to a temporary lack in blood flow to the brain. [utmc.utoledo.edu]

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Hyperkalemia

The Brugada syndrome is a genetic disease (mutation of the SCN5A gene) that predisposes to syncope and life-threatening sudden cardiac death. [ncbi.nlm.nih.gov]

Argulian E (2009) An unusual case of syncope. Am J Med 122: 636-638. [omicsonline.org]

Amal Mattu’s ECG Case of the Week – December 4, 2017 HPI: A 60-year-old male is brought to the ED for lightheadedness and near-syncope. [ecgweekly.com]

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Hypertrophic Cardiomyopathy

Patients who have family history of sudden cardiac death ; unexplained fainting spell; severe thickening of heart muscle or dangerous heart rhythm, are considered to be at [nhcs.com.sg]

Obstructed blood flow can cause shortness of breath with exertion, chest pain, dizziness and fainting spells. Dilated cardiomyopathy. [mayoclinic.org]

A "near-miss" sudden cardiac death (a life-threatening abnormal rhythm that self-converts) may appear to be a "fainting spell." [mottchildren.org]

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Pelvic Inflammatory Disease

Centers for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30333, USA 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC-INFO Self-Study STD Modules for Clinicians - Pelvic Inflammatory Disease (PID) Epidemiology Introduction Pelvic inflammatory disease (PID) is a clinical syndrome in women[…] [www2a.cdc.gov]

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Cor Pulmonale

Symptoms you may have are: Fainting spells during activity Chest discomfort, usually in the front of the chest Chest pain Swelling of the feet or ankles Symptoms of lung disorders [nlm.nih.gov]

As the disease worsens, the following symptoms may occur with lighter activity, or even while you’re resting: 4 Fainting spells with activity Chest discomfort and/or chest [inogen.com]

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