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自我诱发伸展性晕厥:一种罕见的非癫痫性发作事件。病例报告及文献综述。

Self-Induced Stretch Syncope: An Unusual Non-Epileptic Paroxysmal Event. A Case Report and Literature Mini-Review.

作者信息

Mercante Anna, Pizza Fabio, Pondrelli Federica, Zini Andrea, Cirillo Luigi, Tinuper Paolo, Liguori Rocco, Migliaccio Ludovica, Vandi Stefano, Gobbi Giuseppe, Plazzi Giuseppe

机构信息

Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

出版信息

Clin Med Insights Pediatr. 2024 Sep 11;18:11795565241249596. doi: 10.1177/11795565241249596. eCollection 2024.

DOI:10.1177/11795565241249596
PMID:39281040
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11402079/
Abstract

Stretch syncope (SS) is a benign, uncommon, distinct condition described mainly in adolescent males. It is responsible for paroxysmal events started by stereotyped stretching actions with neck hyperextension, culminating in alteration of consciousness. Motor manifestations are often present and may be associated with a generalized slowing of the electroencephalographic activity, challenging the diagnosis. Despite a few cases reported in the literature, different mechanisms have been implied in the pathogenesis, involving both local and systemic hemodynamic phenomena. Here, we report on an 8-year-old girl with self-induced SS, providing new insights into the related neurophysiological profile and discussing the possible etiology. Our evidence of transient and dynamic vascular impairment supports the hypothesis of SS as a multifactorial disorder.

摘要

伸展性晕厥(SS)是一种主要在青春期男性中描述的良性、罕见且独特的病症。它是由颈部过度伸展的刻板伸展动作引发的阵发性事件,最终导致意识改变。常伴有运动表现,可能与脑电图活动普遍减慢有关,这给诊断带来挑战。尽管文献中报道了一些病例,但发病机制涉及不同的机制,包括局部和全身血流动力学现象。在此,我们报告一名8岁自我诱发SS的女孩,为相关神经生理学特征提供新见解,并讨论可能的病因。我们关于短暂和动态血管损伤的证据支持SS是一种多因素疾病的假说。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2ad/11402079/ce7252fc2857/10.1177_11795565241249596-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2ad/11402079/ce7252fc2857/10.1177_11795565241249596-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2ad/11402079/ce7252fc2857/10.1177_11795565241249596-fig1.jpg

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Self-Induced Stretch Syncope: An Unusual Non-Epileptic Paroxysmal Event. A Case Report and Literature Mini-Review.自我诱发伸展性晕厥:一种罕见的非癫痫性发作事件。病例报告及文献综述。
Clin Med Insights Pediatr. 2024 Sep 11;18:11795565241249596. doi: 10.1177/11795565241249596. eCollection 2024.
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Stretch-induced blood pressure moderation: A potential basis for the sense of well-being accompanying stretching of upper back and neck muscles.拉伸诱导的血压调节:上背部和颈部肌肉拉伸时伴随的幸福感的潜在基础。
Physiol Rep. 2025 Sep;13(18):e70569. doi: 10.14814/phy2.70569.

本文引用的文献

1
Clinical Reasoning: A Young Man With Daily Episodes of Altered Awareness.临床推理:一名意识改变发作频繁的年轻男性。
Neurology. 2022 Mar 15;98(11):e1197-e1203. doi: 10.1212/WNL.0000000000200049. Epub 2022 Jan 20.
2
Stretch syncope or epileptic seizure? A pathologic hypothesis for self-induced stretch syncope.伸展性晕厥还是癫痫发作?一种病理性假说解释自发生长性晕厥。
Neurophysiol Clin. 2020 Oct;50(5):383-386. doi: 10.1016/j.neucli.2020.08.002. Epub 2020 Nov 7.
3
Understanding jugular venous outflow disturbance.了解颈静脉流出障碍。
CNS Neurosci Ther. 2018 Jun;24(6):473-482. doi: 10.1111/cns.12859. Epub 2018 Apr 23.
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Non epileptic paroxysmal events in childhood.儿童非癫痫性发作性事件
Turk Pediatri Ars. 2017 Jun 1;52(2):59-65. doi: 10.5152/TurkPediatriArs.2017.4588. eCollection 2017 Jun.
5
Recurrent syncope associated with idiopathic jugular vein stenosis. Report of a young female patient.与特发性颈静脉狭窄相关的复发性晕厥。一名年轻女性患者的报告。
Herz. 2015 Jun;40(4):722-4. doi: 10.1007/s00059-014-4074-5. Epub 2014 Jun 19.
6
Exaggerated Valsalva maneuver may explain stretch syncope in an adolescent.剧烈的瓦尔萨尔瓦动作可能解释了青少年的伸展性晕厥。
Pediatr Neurol. 2011 Nov;45(5):338-40. doi: 10.1016/j.pediatrneurol.2011.08.011.
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Stretch syncope: reflex vasodepressor faints easily mistaken for epilepsy.伸展性晕厥:易误诊为癫痫的反射性血管抑制性晕厥。
Epilepsy Behav. 2011 Mar;20(3):450-3. doi: 10.1016/j.yebeh.2010.12.013. Epub 2011 Feb 15.
8
Symptoms and signs of syncope: a review of the link between physiology and clinical clues.晕厥的症状和体征:生理学与临床线索之间联系的综述。
Brain. 2009 Oct;132(Pt 10):2630-42. doi: 10.1093/brain/awp179. Epub 2009 Jul 8.
9
Self-induced stretch syncope of adolescence: a video-EEG documentation.青少年自发性伸展性晕厥:一份视频脑电图记录
Epileptic Disord. 2007 Dec;9(4):413-7. doi: 10.1684/epd.2007.0133. Epub 2007 Nov 30.
10
Mechanical compression of the extracranial vertebral artery during neck rotation.颈部旋转时颅外椎动脉的机械性压迫。
Neurology. 2003 Sep 23;61(6):845-7. doi: 10.1212/01.wnl.0000078081.12097.ae.