Vestibular syncope.
Journal
Current opinion in neurology
ISSN: 1473-6551
Titre abrégé: Curr Opin Neurol
Pays: England
ID NLM: 9319162
Informations de publication
Date de publication:
01 Feb 2024
01 Feb 2024
Historique:
medline:
9
1
2024
pubmed:
9
1
2024
entrez:
9
1
2024
Statut:
ppublish
Résumé
This review considers recent observations on vestibular syncope in terms of clinical features, laboratory findings, and potential mechanisms. Vestibular syncope, potentially associated with severe fall-related injuries, may develop multiple times in about one-third of patients. Meniere's disease and benign paroxysmal positional vertigo are the most common causes of vestibular syncope, but the underlying disorders remain elusive in 62% of cases with vestibular syncope. The postictal orthostatic blood pressure test exhibits a lower diagnostic yield. Vestibular function tests, such as cervical vestibular-evoked myogenic potentials and video head impulse tests, can reveal one or more abnormal findings, suggesting compensated or ongoing minor vestibular dysfunctions. The pathomechanism of syncope is assumed to be the erroneous interaction between the vestibulo-sympathetic reflex and the baroreflex that have different operating mechanisms and action latencies. The central vestibular system, which estimates gravity orientation and inertia motion may also play an important role in abnormal vestibulo-sympathetic reflex. Vestibular disorders elicit erroneous cardiovascular responses by providing false vestibular information. The results include vertigo-induced hypertension or hypotension, which can ultimately lead to syncope in susceptible patients.
Identifiants
pubmed: 38193502
doi: 10.1097/WCO.0000000000001226
pii: 00019052-202402000-00010
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
66-73Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
Saklani P, Krahn A, Klein G. Syncope. Circulation 2013; 127:1330–1339.
Brignole M, Moya A, de Lange FJ, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J 2018; 39:1883–1948.
Goldberger ZD, Petek BJ, Brignole M, et al. ACC/AHA/HRS versus ESC guidelines for the diagnosis and management of syncope: JACC guideline comparison. J Am Coll Cardiol 2019; 74:2410–2423.
Soteriades ES, Evans JC, Larson MG, et al. Incidence and prognosis of syncope. N Engl J Med 2002; 347:878–885.
van Dijk JG, van Rossum IA, Thijs RD. The pathophysiology of vasovagal syncope: novel insights. Auton Neurosci 2021; 236:102899.
Kaufmann H, Norcliffe-Kaufmann L, Palma JA. Baroreflex dysfunction. N Engl J Med 2020; 382:163–178.
Raphan T, Cohen B, Xiang Y, Yakushin SB. A model of blood pressure, heart rate, and vaso-vagal responses produced by vestibulo-sympathetic activation. Front Neurosci 2016; 10:96.
Pyykko I, Manchaiah V, Zou J, et al. Do patients with Meniere's disease have attacks of syncope? J Neurol 2017; 264:48–54.
Pyykko I, Manchaiah V, Zou J, et al. Vestibular syncope: a disorder associated with drop attack in Meniere's disease. Auris Nasus Larynx 2018; 45:234–241.
Chisholm JC Jr. Vestibular dysfunction presenting as syncope. J Natl Med Assoc 1983; 75:1101–1102.
Kwon E, Lee JY, Kim HJ, et al. Can dyssynergia of vestibulosympathetic and baroreflexes cause vestibular syncope? The hypothesis based on the velocity-storage function. Cerebellum 2022; 21:244–252.
Kwon H, Kwon E, Kim HJ, et al. Vestibular syncope: clinical characteristics and mechanism. Ann Clin Transl Neurol 2022; 9:1616–1625.
Holstein GR, Friedrich VL Jr, Martinelli GP. Projection neurons of the vestibulo-sympathetic reflex pathway. J Comp Neurol 2014; 522:2053–2074.
Balaban CD, Beryozkin G. Vestibular nucleus projections to nucleus tractus solitarius and the dorsal motor nucleus of the vagus nerve: potential substrates for vestibulo-autonomic interactions. Exp Brain Res 1994; 98:200–212.
Fujita H, Kodama T, du Lac S. Modular output circuits of the fastigial nucleus for diverse motor and nonmotor functions of the cerebellar vermis. Elife 2020; 9:e58613.
Cavagna GA, Franzetti P, Heglund NC, Willems P. The determinants of the step frequency in running, trotting and hopping in man and other vertebrates. J Physiol 1988; 399:81–92.
Grossman GE, Leigh RJ, Abel LA, et al. Frequency and velocity of rotational head perturbations during locomotion. Exp Brain Res 1988; 70:470–476.
Yates BJ, Bolton PS, Macefield VG. Vestibulo-sympathetic responses. Compr Physiol 2014; 4:851–887.
Yates BJ, Miller AD. Properties of sympathetic reflexes elicited by natural vestibular stimulation: implications for cardiovascular control. J Neurophysiol 1994; 71:2087–2092.
Woodring SF, Rossiter CD, Yates BJ. Pressor response elicited by nose-up vestibular stimulation in cats. Exp Brain Res 1997; 113:165–168.
Matsuda T, Gotoh TM, Tanaka K, et al. Vestibulosympathetic reflex mediates the pressor response to hypergravity in conscious rats: contribution of the diencephalon. Brain Res 2004; 1028:140–147.
Gotoh TM, Fujiki N, Matsuda T, et al. Roles of baroreflex and vestibulosympathetic reflex in controlling arterial blood pressure during gravitational stress in conscious rats. Am J Physiol Regul Integr Comp Physiol 2004; 286:R25–30.
Yakushin SB, Martinelli GP, Raphan T, et al. Vasovagal oscillations and vasovagal responses produced by the vestibulo-sympathetic reflex in the rat. Front Neurol 2014; 5:37.
Caine SE, Alsop K, Mac Mahon M. Overlooking orthostatic hypotension with routine blood-pressure equipment. Lancet 1998; 352:458.
Choi JY, Park YM, Lee SH, et al. Linear vertigo in benign paroxysmal positional vertigo: prevalence and mechanism. Cerebellum 2021; 20:160–168.
Jauregui-Renaud K, Hermosillo AG, Gomez A, et al. Vestibular function interferes in cardiovascular reflexes. Arch Med Res 2003; 34:200–204.
Kim HA, Yi HA, Lee H. Orthostatic hypotension in acute vestibular neuritis. J Neurol Sci 2015; 358:479–480.
Jauregui-Renaud K, Aw ST, Todd MJ, et al. Benign paroxysmal positional vertigo can interfere with the cardiac response to head-down tilt. Otol Neurotol 2005; 26:484–488.
Jauregui-Renaud K, Reynolds R, Bronstein AM, Gresty MA. Cardio-respiratory responses evoked by transient linear acceleration. Aviat Space Environ Med 2006; 77:114–120.
Wu TY, Taylor JM, Kilfoyle DH, et al. Autonomic dysfunction is a major feature of cerebellar ataxia, neuropathy, vestibular areflexia ’CANVAS’ syndrome. Brain 2014; 137:2649–2656.
Kim JG, Lee JH, Lee SU, et al. Utricular dysfunction in patients with orthostatic hypotension. Clin Auton Res 2022; 32:431–444.
Kim KT, Lee SU, Kim JB, et al. Augmented ocular vestibular-evoked myogenic potentials in postural orthostatic tachycardia syndrome. Clin Auton Res 2023; 33:479–489.
Laurens J, Angelaki DE. The functional significance of velocity storage and its dependence on gravity. Exp Brain Res 2011; 210:407–422.
Choi JY, Kim JH, Kim HJ, et al. Central paroxysmal positional nystagmus: characteristics and possible mechanisms. Neurology 2015; 84:2238–2246.
Choi JY, Glasauer S, Kim JH, et al. Characteristics and mechanism of apogeotropic central positional nystagmus. Brain 2018; 141:762–775.
Choi JY, Koo YJ, Song JM, et al. Effect of a false inertial cue in the velocity-storage circuit on head posture and inertia perception. J Neurosci 2023; 43:1530–1539.
Leigh RJ, Zee DS. The neurology of eye movements. 5th ed.2015; New York: Oxford University Press, 1 online resource.