Familial vasovagal syncope and pseudosyncope: Observations in a case with both natural and adopted siblings |
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| Authors: | Professor Christopher J Mathias DPhil DSc FRCP Kazushi Deguchi MD Katharine Bleasdale-Barr BSc Shelagh Smith FRCP |
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| Institution: | (1) Autonomic Unit, University Department of Clinical Neurology, National Hospital for Neurology and Neurosurgery, London, UK;(2) Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London, UK;(3) the Institute of Neurology, University College, London, UK;(4) Neurovascular Medicine Unit, Division of Neuroscience and Psychological Medicine, Imperial College School of medicine at St. Mary's, London, UK;(5) Neurovascular Medicine Unit (Pickering Unit), Imperial College School of Medicine at St. Mary's, Praed Street, W2 1NY London, UK |
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| Abstract: | This report describes an 11-year-old girl with recurrent syncope beginning at the age of 2 1/2 years. Her paternal grandmother, father, and three of her five natural siblings had similar symptoms, often linked to emotional upsets. There were three adopted children from a single family, and none of these had syncope. Prior to referral there was an increase in attacks, some with convulsions, but with no other features of epilepsy. Vasovagal syncope was confirmed. However, continuous electroencephalogram, blood pressure, and heart rate recordings during attacks indicated that in some episodes there was neither cardiovascular change nor epileptiform activity, implying feigned syncope (pseudosyncope) with pseudoseizures. A psychological origin was sought, found, and in part rectified. The separation of vasovagal syncope from pseudosyncope, in the context of the family history, is discussed. |
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| Keywords: | autonomic nervous system pseudoseizure syncope vasovagal |
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