Nasopharyngeal carcinoma can present with different neurological signs and findings. In this paper, we report a patient presenting with Horner syndrome and syncopal episodes who was finally diagnosed with nasopharyngeal carcinoma. [ncbi.nlm.nih.gov]

CSS has three clinical types, the cardioinhibitory, vasodepressor and mixed type.1-3) The patient in our present report showed 6 seconds of sinus pause, and so this present case is the cardioinhibitory type. [synapse.koreamed.org]

Presenting symptom. Of the 40 patients who had presented with near-syncope, mild carotid sensitivity was present in 6 (15%) and carotid sinus syndrome in 2 (5%). [eplabdigest.com]

DISPOSITION CSS occurs in the elderly population and presents with falls or syncope often resulting in injury. Up to 55% of the patients who present with symptoms will have recurrent symptoms. [encyclopedia.lubopitko-bg.com]

• Falling

  Syncope was defined as a rapid onset of transient and self-limited loss of consciousness usually associated with falling, with complete and spontaneous recovery.9 A fall was defined as coming to rest on the ground or any other lower level without loss [jamanetwork.com]

  Non accidental falls These patients experience recurrent episodes of non accidental and unexplained falls which occur when there is transinet brain hypoperfusion and loss of consciousness. [medicaljoyworks.com]

  CSS is common in older patients, and even for those patients with no history of syncope or falls. [synapse.koreamed.org]

  ROLE OF CSS IN RECURRENT SYNCOPE AND FALLS This retrospective study suggests that CSS is responsible for recurrent falls and syncope in 20.8% of patients referred to a medical outpatient clinic. [pmj.bmj.com]

  Implication for diagnosis of syncope and falls. Arch Intern Med 2006 166 515–520. [ PubMed ] [ Google Scholar ] [ncbi.nlm.nih.gov]

• Pallor

  Unlike the ordinary faint, this syncope is not preceded by pallor, nausea, and sweating. [britannica.com]

  […] ex Conditions.. e73 6 (...) is characterized by diaphoresis, warmth, nausea, and pallor; 3) is associated with vasodepressor hypotension and/or inappropriate bradycardia; and 4) is often followed by fatigue. [tripdatabase.com]

  Metastatic cancer Commonly Associated Conditions Sick sinus syndrome Atrioventricular block Coronary artery disease Diagnosis History Syncope Unexplained falls Abnormal gait and balance Absence of postictal symptoms Physical Exam Bradycardia Hypotension Pallor [tipsdiscover.com]

  […] syncope is still unclear, it is most likely due to a combination of several factors: changes in the autonomic nervous system, hormonal changes, coexistence of multiple pathologies and polypharmacy. 3 Vasovagal syncope is classically preceded by prodromes (pallor [scielo.mec.pt]

  […] feeling cold, sweating, blurred vision Reflex-mediated syncope; vasovagal syncope Aura Seizure; migraine During Manner of falling Slumping Arrhythmia; coronary artery disease Kneeling over Reflex-mediated syncope; orthostatic hypotension Skin color Pallor [aafp.org]

• Blurred Vision

  Syncope can either occur suddenly without any warning symptoms or can be preceded by sweating, nausea, blurred vision, pale skin and lightheadedness. + What Causes Syncope? + How Is Syncope Diagnosed and Treated? + + + + + + + + [biotronik.com]

  This includes a history of seizure activity, prolonged loss of consciousness, disturbance in vision (e.g., diplopia), headache and postictal symptoms; or focal neurologic signs or bruit upon physical examination. [aafp.org]

  As defined by the Heart Rhythm Society, POTS is a clinical syndrome characterized by frequent symptoms that occur with standing (ie, lightheadedness, palpitations, tremor, blurred vision, weakness, fatigue), an increase in heart rate of greater than 30 [clevelandclinicmeded.com]

• Dizziness

  Forty-three participants (40% of those with CSH) had dizziness, presyncope, or syncope during CSM in conjunction with the hypersensitive response. Syncope was present in 18 (17%) and dizziness or presyncope in 25 (23%). [jamanetwork.com]

  The episodes were characterised by hypotension, sharp pain in the right neck, dizziness, and bradycardia. A temporary pacemaker failed to prevent the symptoms, but ephedrine and fludrocortisone produced substantial improvement. [ncbi.nlm.nih.gov]

  Carotid Sinus Hypersensitivity is a potentially dangerous response condition and is normally the cause of dizziness and more. Those with this condition often experience such dizzy spells - even resulting in unexplained falling over. [private-scuba.com]

  Recurrent dizziness This is also a result of brain hypopperfusion as described above. Recurrent dizziness This is also a result of brain hypopperfusion as described above. [medicaljoyworks.com]

  In this condition dizziness, pre-syncope or syncope may be precipitated by any manoeuvre which causes mechanical stimulation of the carotid sinus – such as turning the head, looking up, or wearing tight collars. [syncope.co.uk]

• Drop Attacks

  Synonyms English : Attack, Drop Cardiogenic Syncope Cardiogenic Syncopes Carotid Sinus Syncope Carotid Sinus Syncopes Convulsive Syncope Convulsive Syncopes Deglutitional Syncope Deglutitional Syncopes Drop Attack Drop Attacks Effort Syncope Effort Syncopes [decs.bvs.br]

  The asymptomatic groups of community‐dwelling older individuals were not necessarily healthy controls but were individuals without the symptoms of syncope, falls, or drop attacks. [ahajournals.org]

  These falls/attacks are called cryptogenic drop attacks. References:[5][12] The differential diagnoses listed here are not exhaustive. Treatment Complications References:[5] We list the most important complications. The selection is not exhaustive. [amboss.com]

  In an additional prospective, controlled cohort study of 1,149 subjects presenting with unexplained syncope and drop attacks, 19% had carotid sinus hypersensitivity and 31% of these had a positive response only with head-up tilt, giving the upright positive [onlinejacc.org]

• Vertigo

  Syncopal Vertigos, Syncopal [decs.bvs.br]

  The vertigos gradually increased in frequency and intensity since they started one month prior her admission. [head-face-med.biomedcentral.com]

  […] as is possible Lay the diver down on any solid surface after surfacing Contact an emergency hotline for advice such as Divers Alert Network (DAN) Scuba Injuries | Overview | Drowning | Shock | Pulmonary Barotrauma | Salt Water Aspiration Syndrome | Vertigo [private-scuba.com]

  Synonym(s): Charcot vertigo ; tussive syncope Charcot spine Charcot syndrome - a condition caused by ischemia of the muscles. [medical-dictionary.thefreedictionary.com]

  Two other patients described mild symptoms (dizziness or vertigo) but had no evidence of CSH. Only one patient had persistent symptoms associated with objectively demonstrable CSH. [jvascsurg.org]

The workup must exclude other causes of syncope as guided by the history and the physical examination. [encyclopedia.lubopitko-bg.com]

[…] trialled with limited success 4 Midodrine, fludrocortisone and sertraline were previously trialled by Sharma et al without any success. 6 This case highlights the importance of high clinical suspicion and thorough clinical examination in the diagnostic workup [nzma.org.nz]

The workup of unexplained syncope depends on the presence or absence of heart disease: electrophysiologic study if the patient has heart disease, tilt-table testing in those without heart disease, and prolonged rhythm monitoring in both cases if syncope [mdedge.com]

He had extensive workup that included EEG (Electroencephalography), CT (computed Tomography) scan of head, echocardiography and cardiac stress test. All of these diagnostic studies performed were found to be unremarkable. [ispub.com]

The term induced carotid sinus syndrome refers to a clinical situation in which a patient has no clear history of accidental mechanical manipulation of the carotid sinuses and has a negative result from workup for syncope, except for a hypersensitive [emedicine.medscape.com]

• Multiple Pulmonary Nodules

  The nodes were directly anterior to, and encroaching on, the carotid sheath at multiple levels including the carotid sinus. There were also multiple pulmonary nodules but no other metastatic spread. [nzma.org.nz]

• White Matter Lesions

  Carotid sinus syndrome is common in dementia with Lewy bodies and correlates with deep white matter lesions. J Neurol Neurosurg Psychiatry. 2004 Jul. 75(7):966-71. [Medline]. Kenny RA, O'Shea D, Parry SW. [emedicine.medscape.com]

  matter lesions, J Neurol Neurosurg Psychiatry, 2004, vol. 75 (pg. 966 - 71 ) © The European Society of Cardiology 2007. [academic.oup.com]

Combined drug treatment with a vasoconstrictor and plasma volume expander produced an improvement in symptoms but did not eliminate them. [ncbi.nlm.nih.gov]

AB - The patient with a hypersensitive carotid sinus reflex and syncope may pose special challenges in evaluation and treatment. [mayoclinic.pure.elsevier.com]

Patients on any form of treatment require regular follow-up to monitor the effects of treatment versus the adverse effects of intervention. Follow-up for patients who rarely have symptoms may be on an as-needed basis. Seifer C. [emedicine.medscape.com]

[11] Patients with CSH showing a reduction in blood pressure after an carotid sinus stimulation have a worse prognosis than those with a pure cardio-inhibitory response or a lack of vasodepressor response.[11] [patient.info]

In every case the goal should be to determine the cause of syncope with sufficient confidence to provide patients and family members with a reliable assessment of prognosis, recurrence risk, and treatment options. [ncbi.nlm.nih.gov]

Short- and long-term prognosis of syncope, risk factors, and role of hospital admission: results from the STePS (Short-Term Prognosis of Syncope) study. J Am Coll Cardiol. 2008 Jan 22. 51(3):276-83. [Medline]. Andrea U, Attilio DR, Franco G, et al. [medscape.com]

Prognosis Cardiac syncope has a poorer prognosis than other forms of syncope. The 1-year endpoint mortality has been shown to be as high as 18-33%. [emedicine.medscape.com]

He declined to receive palliative radiation therapy to the cervical tumor or implantation of a temporary or permanent pacemaker because of their invasive nature and his poor prognosis. [bpsmedicine.biomedcentral.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Given the wide variety of etiologies and concern over potentially missing an important etiology, diagnostic testing can become elaborate, expensive, and frequently low yield. [journalofhospitalmedicine.com]

Syncope Summary Etiology Clinical features Diagnostics Differential diagnoses Treatment Complications [amboss.com]

Abstract Of interest for years as a readily demonstrable etiologic factor in certain cases of syncopal or convulsive attacks, the cardioinhibitory carotid sinus syndrome has itself fallen under suspicion as a manifestation of myocardial disease. [annals.org]

[…] merely to establish an etiological diagnosis ( Figure 1 ). [revportcardiol.org]

Special attention has also been paid to epidemiology and prevention, discussing all the issues concerned. [books.google.com]

[…] syncope and may be classified as: Spontaneous CSS: syncope after accidental mechanical manipulation (trigger) of the carotid sinuses (e.g., shaving, tight collars, or tumors) Induced CSS: syncope diagnosed by CSM, although no mechanical trigger is found Epidemiology [unboundmedicine.com]

Epidemiology Although baroreceptor function usually diminishes with age, some people experience hypersensitive carotid baroreflexes. CSH is rare before the age of 50. [patient.info]

SYNONYMS Carotid sinus syncope CSS EPIDEMIOLOGY & DEMOGRAPHICS • The incidence of carotid sinus hypersensitivity is 15% in the adult population. • The incidence increases with age. • Men are affected more often than women (2:1). • Carotid sinus syndrome [encyclopedia.lubopitko-bg.com]

System(s) affected: Cardiovascular; Nervous Synonym(s): Carotid sinus syncope; Carotid sinus hypersensitivity Epidemiology Predominant age: Elderly Predominant sex: Male > Female (2:1) Geriatric Considerations More likely to occur in elderly Can be a [tipsdiscover.com]

Cerebral hemodynamic disturbances may play a crucial role in the pathophysiology of syncope with normal sinus rhythm and normotension. Moreover, direct depression of the CNS following carotid sinus distension is likely to be involved. [ncbi.nlm.nih.gov]

The purpose of this book is to present a focused approach to the pathophysiology, diagnosis, and management of the most common autonomic disorders that may present to the clinical neurologist. Autonomic Neurology is divided into 3 sections. [books.google.com]

Claydon e13448 First Published: 16 October 2017 Despite its high prevalence in the elderly, and reported association with devastating episodes of syncope and falls, the pathophysiology of carotid sinus hypersensitivity (CSH) remains unknown. [physreports.physiology.org]

Etiology and Pathophysiology The exact mechanism of CSH remains unknown. [unboundmedicine.com]

A temporary pacemaker failed to prevent the symptoms, but ephedrine and fludrocortisone produced substantial improvement. [ncbi.nlm.nih.gov]

Volume maintenance can control the vasodepressor form of CSH, preventing syncopal episodes by maintaining adequate central volume. [emedicine.medscape.com]

All the patients with NCS were treated conservatively (two patients were treated with fludrocortisone but the majority were advised on ways to prevent their symptoms; appendix ). [pmj.bmj.com]

Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]