Journal Article


R A Kenny
B King-Kallimanis
C P Rice
J F Meaney
J A Harbison
D J Ryan



follow up symptoms magnetic resonance imaging mri syncope vasovagal neurological risk factors syncope cerebral infarction

Syncope causes transient focal neurological symptoms. (2015)

Abstract The prevalence of focal neurology (FN) as a consequence of syncope is unknown. The aim of the study was to determine its prevalence, risk factors and short-term consequences. A consecutive sample of syncope-unit attendees during a 9-month period had detailed diagnostic syncope evaluation as per European Cardiac Society guidelines coupled with assessment for FN present during syncope/pre-syncope by screening questionnaire, follow-up interview and neuroimaging (1.5T magnetic resonance imaging [MRI]). All participants were followed up for 24 months. Risk factors for FN were identified by comparing FN cases with syncope controls without FN (3:1 ratio). Five-hundred and forty consecutively attended for investigation of syncope (n = 401) and pre-syncope (n = 139). Thirty-one (5.7%) had FN events during hypotensive symptoms, mean age 49 years (19-85). The majority of FN cases had vasovagal syncope (VVS); 22 (71%), whereas eight had OH (25.8%) and one (3.2%) had cardiac arrhythmia. Median duration of FN was 15 min (IQR: 34.5). MRI in 28 (90%) was normal and in 3, old cerebral infarction was evident. Risk factors for FN/syncope were frequent syncope (P = 0·008), childhood syncope (P < 0.0005) and delayed diastolic recovery during active stand (P = 0·02). During 24-month follow-up and targeted intervention, no patients developed recurrence of FN. One in 20 patients with syncope/pre-syncope have co-extant FN, which during 24-month follow-up, does not progress to a persistent deficit (>24 h). Awareness of co-occurrence of FN and syncope is important as stroke misdiagnosis results in aggressive anti-hypertensive management and future events may ensue.
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Full list of authors on original publication

R A Kenny, B King-Kallimanis, C P Rice, J F Meaney, J A Harbison, D J Ryan

Experts in our system

Rose Anne Kenny
Trinity College Dublin
Total Publications: 252
Bellinda L King-Kallimanis
Trinity College Dublin
Total Publications: 7
James Meaney
Trinity College Dublin
Total Publications: 29
Joseph A Harbison
Trinity College Dublin
Total Publications: 27