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TITLE:
Neurally mediated syncope and syncope due to
autonomic failure: differences and similarities.
AUTHOR:
Kaufmann H
AUTHOR AFFILIATION:
Department of Neurology, Mount Sinai School of
Medicine, New York, New York 10029, USA.
SOURCE:
J Clin Neurophysiol 1997 May;14(3):183-96
NLM CIT. ID:
97386309
ABSTRACT:
Syncope is a transient loss of consciousness and
postural tone caused by a global reduction of blood flow to the brain. Abnormalities in
autonomic cardiovascular control can impair blood supply to the brain and produce syncope
in two different disorders: autonomic failure and neurally mediated syncope. In autonomic
failure, sympathetic efferent activity is chronically impaired so that vasoconstriction is
deficient, upon standing blood pressure always falls (i.e., orthostatic hypotension), and
syncope or presyncope occurs. Conversely, in neurally mediated syncope, the failure of
sympathetic efferent vasoconstrictor traffic (and hypotension) occurs episodically and in
response to a trigger. Between syncopal episodes, patients with neurally mediated syncope
have normal blood pressure and orthostatic tolerance. This article reviews the
characteristics of autonomic failure and describes in more detail the pathophysiology,
diagnosis, and treatment of neurally mediated syncope.
MAIN MESH SUBJECTS:
Autonomic Nervous System
Diseases/*COMPLICATIONS/DIAGNOSIS/ PHYSIOPATHOLOGY/THERAPY
Peripheral Nervous System Diseases/*COMPLICATIONS/DIAGNOSIS/ PHYSIOPATHOLOGY
Syncope/*ETIOLOGY/PHYSIOPATHOLOGY
ADDITIONAL MESH SUBJECTS:
Cardiac Pacing, Artificial
Cerebrovascular Circulation
Circadian Rhythm/PHYSIOLOGY
Diagnosis, Differential
Human
Hypotension, Orthostatic/DIAGNOSIS/ETIOLOGY
Posture/PHYSIOLOGY
Syncope, Vasovagal/DIAGNOSIS
Tilt-Table Test
Vasoconstriction/PHYSIOLOGY
PUBLICATION TYPES:
JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
LANGUAGE:
Eng
On Sabbatical!
When my office
lease expired at the end of 2004, I decided to turn it into a
"sabbatical" from my private practice. Many years ago, in my
grandfather's 89th year of life, he told me, "John, it is important
to smell the roses while you can still smell them." His life
gave living a very good reputation. It is also true that the
pursuit of that philosophy required my grandfather to to re-open his
assay office/ore market in Wickenburg, Arizona as a 75-year-old because
he had run a little short of retirement money. Thus, if blessed with his
luck and health, I'll be back.. --jjh
