Do patients with Meniere's disease have attacks of syncope?

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Pyykko , I , Manchaiah , V , Zou , J , Levo , H & Kentala , E 2017 , ' Do patients with Meniere's disease have attacks of syncope? ' , Journal of Neurology , vol. 264 , pp. S48-S54 .

Title: Do patients with Meniere's disease have attacks of syncope?
Author: Pyykko, Ilmari; Manchaiah, Vinaya; Zou, Jing; Levo, Hilla; Kentala, Erna
Contributor organization: Korva-, nenä- ja kurkkutautien klinikka
University of Helsinki
HUS Head and Neck Center
Date: 2017-10
Language: eng
Number of pages: 7
Belongs to series: Journal of Neurology
ISSN: 0340-5354
Abstract: The aim of the present study was to evaluate the prevalence and associated factors for syncope among patients with Meniere's disease (MD). An attack of syncope was defined as a sudden and transient loss of consciousness, which subsides spontaneously and without a localizing neurological deficit. The study used an across-sectional survey design. Information from a database consisting of 961 individuals was collected from the Finnish Meniere Association. The data contained case histories, general health-related quality of life (HRQoL), and impact measurements of the complaints. In the current study sample, syncope occurred in 12.3% of the patients with MD. It was more prevalent among elderly persons and among those with a longer duration of MD. Syncope was significantly associated with disturbances of otolith function reflected as Tumarkin attacks, gait and balance problems, environmental change of pressure, and physical strain. It was also associated with visual blurring; in fact, patients with otolith dysfunction in MD often experience visual field changes. It was also associated with headache, but not with migraine. Syncope was experienced as frightening and HRQoL was significantly worsened. The patient had higher anxiety scores, and suffered more from fatigue. The results demonstrate that neurally mediated syncope occurs in patients with an advanced form of MD who suffer from Tumarkin attacks due to failure in otolith function. The mechanism seems to be triggered through the vestibular sympathetic reflex when the otolith system fails due to disrupted utricular otolithic membrane mediate erroneous positional information from the otolith organ to the vasomotor centres in the brain stem and medulla.
Subject: Meniere's disease
Tumarkin attacks
Drop attack
Fainting vestibular disorder
Otolith organ
3125 Otorhinolaryngology, ophthalmology
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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