Kaplan C, Kocaman S A, Durakoğlugil M E, Kaya E, Senol M G
Department of Neurology, Bursa Military Hospital, Bursa, Turkey.
Herz. 2013 Sep;38(6):683-4. doi: 10.1007/s00059-012-3734-6. Epub 2013 Apr 17.
Neurocardiogenic syncope comprises situations triggered by neurological reflexes resulting in abnormal responses of the neurocardiovascular system that cause loss of consciousness. A vast number of clinical conditions may cause this disorder including pain, defecation, micturition, swallowing, cough, sudden fear or excitement, exercise, and long-time standing. Treatment options for syncope prevention are not satisfactory. Several agents were used for pharmacological treatment without success. Selective inhibitors of neuronal norepinephrine transporter (NET) like duloxetine may play a role in neurally mediated syncope by increasing synaptic norepinephrine levels. Therefore, we report the effect of duloxetine in a patient with pain-induced syncope resistant to standard regimens.
神经心源性晕厥包括由神经反射触发的情况，这些反射会导致神经心血管系统的异常反应，进而引起意识丧失。大量临床病症可能导致这种疾病，包括疼痛、排便、排尿、吞咽、咳嗽、突然的恐惧或兴奋、运动以及长时间站立。预防晕厥的治疗选择并不令人满意。曾使用多种药物进行治疗但未成功。像度洛西汀这样的神经元去甲肾上腺素转运体（NET）选择性抑制剂可能通过提高突触去甲肾上腺素水平在神经介导的晕厥中发挥作用。因此，我们报告了度洛西汀对一名对标准治疗方案耐药的疼痛性晕厥患者的疗效。
