Objective: This review focuses on syncope in diabetic patients who suffer from hypoglycemia. Clinically, transient loss of consciousness during hypoglycemia appears similar to vasovagal syncope. Research Design and Me...Objective: This review focuses on syncope in diabetic patients who suffer from hypoglycemia. Clinically, transient loss of consciousness during hypoglycemia appears similar to vasovagal syncope. Research Design and Methods: Current understanding of this problem is based on physicians’ personal experiences as well as on published case reports. It is difficult to explain a temporary loss of consciousness as a result of hypoglycemia. Demonstration that hypoglycemia can be transient, with the patient suffering from neuroglycopenia without autonomic symptoms due to delayed counterregulation, might be a first step in confirming that a diabetic patient suffered from a transient loss of consciousness with spontaneous recovery. Results: Hypoglycemic syncope is uncommon, affecting 1.9% of diabetic patients using insulin therapy. It is characterized clinically by brief periods of unconsciousness with slow recovery and without loss of postural muscle tone. The difficulty in correlating loss of consciousness to hypoglycemia arises from mismatching symptoms, that is, there may be mental symptoms such as confusion, loss of memory or consciousness, in the absence of autonomic manifestations such as sweating or blurred vision. There are currently no established glucose values that define the level of hypoglycemia that causes loss of consciousness. Conclusion: Hypoglycemic syncope should be suspected in older diabetic patients with preserved postural tone, usually but not always using insulin therapy, who show a slow recovery from transient loss of consciousness with persisting neurological impairment and low blood glucose levels.展开更多
This review examines the pathogenesis of Carotid Sinus Hypersensitivity (CSH) by describing the different hypotheses that exist in literature. One hypothesis is that CSH is not a disease of the heart but of the centra...This review examines the pathogenesis of Carotid Sinus Hypersensitivity (CSH) by describing the different hypotheses that exist in literature. One hypothesis is that CSH is not a disease of the heart but of the central and/or peripheral nerv- ous system where the heart is the victim. CSH is associated with cognitive disturbance, vasovagal syncope and ortho- static hypotension. Another hypothesis is that the CSH is considered a syndrome or a symptom associated with different diseases so as to require a diagnostic framework. This Hypothesis is the basis of frequent recurrences that are associated with the pacemaker implant therapy only.展开更多
文摘Objective: This review focuses on syncope in diabetic patients who suffer from hypoglycemia. Clinically, transient loss of consciousness during hypoglycemia appears similar to vasovagal syncope. Research Design and Methods: Current understanding of this problem is based on physicians’ personal experiences as well as on published case reports. It is difficult to explain a temporary loss of consciousness as a result of hypoglycemia. Demonstration that hypoglycemia can be transient, with the patient suffering from neuroglycopenia without autonomic symptoms due to delayed counterregulation, might be a first step in confirming that a diabetic patient suffered from a transient loss of consciousness with spontaneous recovery. Results: Hypoglycemic syncope is uncommon, affecting 1.9% of diabetic patients using insulin therapy. It is characterized clinically by brief periods of unconsciousness with slow recovery and without loss of postural muscle tone. The difficulty in correlating loss of consciousness to hypoglycemia arises from mismatching symptoms, that is, there may be mental symptoms such as confusion, loss of memory or consciousness, in the absence of autonomic manifestations such as sweating or blurred vision. There are currently no established glucose values that define the level of hypoglycemia that causes loss of consciousness. Conclusion: Hypoglycemic syncope should be suspected in older diabetic patients with preserved postural tone, usually but not always using insulin therapy, who show a slow recovery from transient loss of consciousness with persisting neurological impairment and low blood glucose levels.
文摘This review examines the pathogenesis of Carotid Sinus Hypersensitivity (CSH) by describing the different hypotheses that exist in literature. One hypothesis is that CSH is not a disease of the heart but of the central and/or peripheral nerv- ous system where the heart is the victim. CSH is associated with cognitive disturbance, vasovagal syncope and ortho- static hypotension. Another hypothesis is that the CSH is considered a syndrome or a symptom associated with different diseases so as to require a diagnostic framework. This Hypothesis is the basis of frequent recurrences that are associated with the pacemaker implant therapy only.
