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Related Experiment Videos

The eye movements of syncope

T Lempert1, M von Brevern

  • 1Neurologische Abteilung, Virchow-Klinikum, Humboldt Universität, Berlin, Germany.

Neurology
|April 1, 1996
PubMed
Summary

Fainting (syncope) causes specific eye movements like downbeat nystagmus and upward deviation due to vestibular disinhibition. This study observed these changes and increased vestibulo-ocular reflex gain during induced syncope.

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Cardiology

Background:

  • Syncope, or fainting, is a transient loss of consciousness often accompanied by autonomic nervous system dysfunction.
  • Understanding the associated neurological and oculomotor changes during syncope is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the eye movement patterns and vestibulo-ocular reflex (VOR) gain during induced syncope in healthy volunteers.
  • To explore the potential mechanisms, such as cerebellar hypoperfusion, underlying these oculomotor changes.

Main Methods:

  • Videotaped eye movements in 25 healthy volunteers undergoing induced syncope via hyperventilation and Valsalva maneuver on a tilt table.
  • Recorded eye movements using electro-oculography in 3 additional subjects during syncope induced by sinusoidal oscillation on a rotating chair.
  • Measured the gain of the vestibulo-ocular reflex (VOR) during syncope.

Main Results:

  • Fourteen of 25 subjects on the tilt table experienced syncope.
  • Observed oculomotor phenomena included downbeat nystagmus (DBN) evolving into upward eye deviation (7 subjects) or isolated tonic upward deviation (6 subjects).
  • The VOR gain increased by an average of 65% during syncope, particularly with concurrent vestibular stimulation.

Conclusions:

  • Induced syncope is associated with distinct eye movement abnormalities, including DBN and upward eye deviation.
  • Increased VOR gain during syncope suggests a role for vestibular system changes.
  • Cerebellar hypoperfusion leading to vestibular disinhibition is a potential cause for the observed DBN, upward eye deviation, and increased VOR gain.

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