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Auricular syncope

Published online by Cambridge University Press:  12 October 2007

A Thakar ,
K K Deepak  and
S Shyam Kumar
A Thakar*
Affiliation:
Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
K K Deepak
Affiliation:
Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
S Shyam Kumar
Affiliation:
Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
*
Address for correspondence: Dr A Thakar, Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi 110029, India. Fax: 00 91 11 26588663 E-mail: meenaal@vsnl.com
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Abstract

Objective:

To describe a previously unreported syndrome of recurrent syncopal attacks provoked by light stimulation of the external auditory canal.

Case report:

A 13-year-old girl had been receiving treatment for presumed absence seizures, with inadequate treatment response. Imaging was normal. Careful history taking indicated that the recurrent syncopal attacks were precipitated by external auditory canal stimulation. Targeted autonomic function tests confirmed a hyperactive vagal response, with documented significant bradycardia and lightheadedness, provoked by mild stimulation of the posterior wall of the left external auditory canal. Abstinence from ear scratching led to complete alleviation of symptoms without any pharmacological treatment.

Conclusions:

Reflex syncope consequent to stimulation of the auricular branch of the vagus nerve is proposed as the pathophysiological mechanism for this previously undocumented syndrome.

Keywords

Vagus NerveExternal Auditory CanalSyncope
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 10 , October 2008 , pp. 1115 - 1117
Copyright
Copyright © JLO (1984) Limited 2008

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