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European Heart Journal 1985 6(11):979-984;
Copyright © 1985 by the European Society of Cardiology.
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© 1985 The European Society of Cardiology

Syncope and tumours in the neck: carotid sinus or glossopharyngeal syndrome?

R. CIOGNA, A. CURNIS, L. DEI CAS and O. VISIOLI

Cattedra di Cardiologia, Brescia University Brescia, Italy

Received 7 January 1985; revised 26 June 1985; .

Address for Correspondence: Raoul Cicogna, Via Pendotina, 21, 25100 Brescia, Italy

Abstract

Three patients with syncope, lateral cervical metastasis and/or carotid sinus hyper sensitivity are described. The initial diagnosis in these patients was carotid sinus syndrome (CSS). Further investigations, including computerized tomography, showed in all the patients a malignant tumour localized in the epipharynx or nearby. We think that the symptomatology in our patients can be attributed to the epipharyngeal tumour. The mechanism of the attacks could be similar to that which operates in the glossopharyngeal neuralgia-asystole syndrome, but does not involve pain pathways. The clinical picture in our patients was quite different from the classic CSS; the vaso-vagal attacks were more prolonged, severe, and relapsing and were mainly vasodepressor. Symptoms were not improved by demand ventricular pacing, but A-V sequential pacing achieved a moderate improvement in two patients

Key Words: Carotid sinus syndrome • syncope • glossopharyngeal neuralgia • cardiac pacemaker


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