A 56-year-old woman was admitted for recurrent syncope. She went through subtotal gastrectomy with intraoperative vagotomy 1 month prior. She experienced recurrent loss of consciousness for a few seconds when trying to eat or brush her tongue (video on the Neurology® Web site at www.neurology.org). Syncope in glossopharyngeal neuralgia may be caused by bradycardia related to the glossopharyngeal-vagal reflex.1 She had no inherent cardiac history such as an atrioventricular block. In our patient, denervation hypersensitivity or synkinesis of the vagus nerve by a glossopharyngeal input might be plausible mechanism. Suppression of theactivation of the hypersensitized nerve by carbamazepine2 gradually decreased heart rate fluctuation and syncope.
AUTHOR CONTRIBUTIONS
H. Im: description of the case. H.J. Kim: preparation of the video file. S. Song: preparation of the video file. H.Y. Kim: design of the study, interpretation of the case, and revising the manuscript.
Footnotes
Supplemental data at www.neurology.org
The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
- Copyright © 2012 by AAN Enterprises, Inc.
REFERENCES
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