Swallow-induced syncope in 5 patients: Electrophysiologic evaluation during swallowing
Ibrahim Aydogdu1, Can Hasdemir1, Ahmet Acarer1
1Departments of Neurology and Clinical Neurophysiology (IA, CE), Cardiology (CH), and Neurology (AA, SA), Ege University, Bornova/Izmir, Turkey.
Neurology. Clinical Practice
|November 30, 2017
Summary
Swallow-induced syncope (SIS) is a brief, reflex reaction originating in the oropharynx, not the esophagus. Pacemaker implantation offers a curative solution for this potentially life-threatening condition.
Area of Science:
- Cardiology
- Neurology
- Physiology
Background:
- Swallow-induced syncope (SIS) is a rare condition requiring further characterization.
- Understanding the underlying mechanisms of SIS is crucial for effective management.
Purpose of the Study:
- To characterize a cohort of patients with swallow-induced syncope (SIS).
- To evaluate the clinical and electrophysiologic features of SIS.
Main Methods:
- Utilized electrocardiographic monitoring and neurophysiologic swallowing assessments.
- Evaluated a cohort of 5 patients diagnosed with SIS, including longitudinal follow-up for 4 patients.
Main Results:
- Electrophysiologic studies revealed an extremely short latency (2-3 seconds) between swallow onset and bradyarrhythmia or asystole in SIS.
- Most SIS patients lacked identifiable neurologic or esophageal disorders.
- SIS presentation varied, occurring with different food types, postures, and frequencies.
Conclusions:
- SIS is triggered by reflex afferent pathways originating in the oropharynx, challenging previous esophageal origin theories.
- Permanent pacemaker placement is a curative treatment for SIS.
- This study provides valuable clinical and electrophysiologic data to aid in SIS diagnosis and treatment.
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