Swallow Syncope After Whiplash Neck Injury

Area of Science:

• Neurology
• Cardiology
• Gastroenterology

Background:

• Swallow syncope is a rare dysautonomic syndrome linked to esophageal or cardiac issues.
• It involves temporary loss of consciousness triggered by swallowing.
• Vagal dysfunction or esophageal mechanoreceptor abnormalities can also cause it.

Observation:

• A 49-year-old healthy female experienced swallow syncope two weeks post-whiplash neck injury.
• Standard cardiac and esophageal evaluations revealed no underlying pathology.
• A provocative tilt-table test with food ingestion confirmed the diagnosis.

Findings:

• The patient's swallow syncope was potentially caused by neck trauma affecting vagal nerve fibers or esophageal mechanoreceptors.
• This suggests a novel mechanism for swallow syncope unrelated to primary cardiac or esophageal disease.

Implications:

• Neck trauma should be considered in the differential diagnosis of swallow syncope.
• Understanding this link may lead to new diagnostic and therapeutic strategies for dysautonomic syndromes.
• Pacemaker implantation effectively resolved symptoms in this case.