Neurally Mediated/Reflex
Indication: Common in young adults, Unexplained Falls
History:
a. Precipitating - Warm/crowded area, pain, emotional distress, fear, coughing, laughing, urination/ defecation, eating
Symptoms: Lightheadedness, dizziness, blurred vision, vertigo
Post-Ictal: Nausea, vomiting, fatigue, Transient Disorientation, Amnesia post event
Vasovagal Syncope
Hx: Age - Young, Premonitory symptoms (e.g., nausea, dizziness) or precipitating factors
Symptoms: Nausea, diaphoretic, abdominal pain
Post Ictus: Myoclonic movement, Incontinence
Carotid Sinus Hypersensitivity
Hx: Head rotation or pressure on the carotid sinus (e.g., shaving, tight collar) can reproduce symptoms; consider in patients with unexplained falls
Situational
Hx: Micturition, post-exercise, postprandial, gastrointestinal stimulation, cough, phobia of needle or blood