Barbash G I, Keren G, Korczyn A D, Sharpless N S, Chayen M, Copperman Y, Laniado S
Electroencephalogr Clin Neurophysiol. 1986 Mar;63(3):231-5. doi: 10.1016/0013-4694(86)90089-1.
Syncope is a rare presentation of glossopharyngeal neuralgia (GN). The mechanisms of the syncope were studied in a patient with recurrent episodes comprising prolonged cardiac standstill and arterial hypotension. During attacks, no supraventricular or ventricular potentials were recorded in the ECG. Atropine prevented the cardiac arrest without affecting the pain, indicating the vagus as the efferent limb of the reflex asystole. Following atropine blood pressure continued to fall during GN attacks, suggesting abolition of sympathetic tone. Indeed, serum norepinephrine levels fell during these attacks. Infiltration of either vagus above the clavicle with local anesthetics did not abolish the cardiac asystole. Carbamazepine and a dual chamber pacemaker were effective in controlling the symptoms of the patient. The results suggest that, during a neuralgic attack, the stimulation excites both vagi, causing asystole and simultaneously abolishes sympathetic tone.
晕厥是舌咽神经痛（GN）的一种罕见表现。对一名反复出现包括长时间心脏停搏和动脉低血压发作的患者的晕厥机制进行了研究。发作期间，心电图未记录到室上性或室性电位。阿托品可预防心脏骤停而不影响疼痛，表明迷走神经是反射性心搏停止的传出支。注射阿托品后，在GN发作期间血压继续下降，提示交感神经张力消失。事实上，这些发作期间血清去甲肾上腺素水平下降。用局部麻醉药浸润锁骨上方的任一迷走神经并不能消除心脏停搏。卡马西平和双腔起搏器可有效控制该患者的症状。结果表明，在神经痛发作期间，刺激会同时兴奋双侧迷走神经，导致心搏停止并同时消除交感神经张力。
