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Related Concept Videos

Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
207
Arteries of the Head and Neck01:26

Arteries of the Head and Neck

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The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
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Chronic Pharyngitis01:23

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Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

195
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Narcolepsy01:07

Narcolepsy

253
Narcolepsy is a chronic sleep disorder characterized by pervasive, uncontrolled sleepiness and other sleep disturbances. One of its hallmark symptoms is an abrupt transition to REM sleep upon falling asleep, which causes symptoms typically associated with this phase to occur unexpectedly during wakefulness. These include the following symptoms, which typically last from a minute or two to half an hour.
253

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Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
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Recurrent syncope from parapharyngeal cancer.

Mark Howard1

  • 1Palliative Care, Saint Francis Hospice, Romford, UK markhoward@sfh.org.uk.

BMJ Supportive & Palliative Care
|July 16, 2021
PubMed
Summary

Head and neck cancer can trigger reflex bradycardia and syncope via the glossopharyngeal nerve. Palliative care patients with parapharyngeal lesions experienced reduced symptoms with anticholinergic agents.

Area of Science:

  • Neurology
  • Oncology
  • Cardiology

Background:

  • The glossopharyngeal nerve can induce reflex bradycardia and syncope in head and neck cancer patients.
  • These syndromes are rare, debilitating, and present with varied clinical features.
  • Parapharyngeal lesions, not just carotid sinus hypersensitivity, can affect the glossopharyngeal nerve.

Purpose of the Study:

  • To report two cases of glossopharyngeal nerve-mediated syncope in head and neck cancer patients managed by palliative care.
  • To highlight the diagnostic challenge and explore treatment options for this rare condition.

Main Methods:

  • Case report of two patients with head and neck cancer presenting with syncope.
  • Review of clinical presentation, diagnostic considerations, and treatment interventions.
Keywords:
head and neckhospice carehospital caresymptoms and symptom management

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  • Focus on palliative care management and symptomatic relief.

    • Main Results:

    • Both patients had parapharyngeal lesions affecting the glossopharyngeal nerve, leading to syncope.
    • Symptomatic treatment options were limited due to patient frailty.
    • Both patients showed some improvement in syncopal symptoms with anticholinergic medications.

    Conclusions:

    • Glossopharyngeal nerve dysfunction due to parapharyngeal lesions is a potential cause of syncope in head and neck cancer.
    • Anticholinergic agents may offer symptomatic relief in frail patients.
    • Accurate diagnosis and tailored palliative care are crucial for managing these debilitating symptoms.