Motta Noemi, Gitto Marco, Castelli Valeria, Tobaldini Eleonora, Montano Nicola, Di Berardino Federica
Audiology Unit, Department of Surgical Sciences Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy.
Department of Clinical Sciences and Community Health, Dipartimento di Eccellenza 2023-2027 University of Milan Milan Italy.
Clin Case Rep. 2024 Nov 29;12(12):e9677. doi: 10.1002/ccr3.9677. eCollection 2024 Dec.
Vestibular syncope is a rare condition in which vertigo may cause syncopal attacks; however, the term has been associated with confusion because it has been ascribed to completely different vestibular and neurological conditions, from dizziness to Menière disease (MD), to the neurovegetative symptoms in benign paroxysmal positional vertigo (BPPV) and central vertebrobasilar hyperfusion. A 75-year-old woman with vasodepressive vasovagal syncope, confirmed by a tilt test with trinitrine administration, was referred for an audiological and vestibular assessment showing an acute unilateral peripheral vestibular deficit on the right side. The diagnosis is peripheral acute vestibular deficits. Interventions and outcomes are vestibular treatment and rehabilitation. The patient's vasovagal symptoms immediately improved and were completely resolved. Peripheral vestibular deficits might also trigger syncopal episodes and must be considered and studied by a complete audiological and vestibular evaluation. By restoring the peripheral vestibular function of the right labyrinth after vestibular treatment, a complete long-term resolution of multiple vasovagal syncopal episodes was observed together with normalization of the tilt test.
前庭性晕厥是一种罕见病症，其中眩晕可能导致晕厥发作；然而，该术语一直存在混淆，因为它被归因于从头晕到梅尼埃病（MD）、良性阵发性位置性眩晕（BPPV）中的神经植物性症状以及中枢椎基底动脉过度灌注等完全不同的前庭和神经病症。一名75岁女性，经服用三硝酸甘油的倾斜试验确诊为血管抑制性血管迷走性晕厥，前来接受听力学和前庭评估，结果显示右侧存在急性单侧外周前庭功能缺损。诊断为外周急性前庭功能缺损。干预措施和结果为前庭治疗与康复。患者的血管迷走性症状立即改善并完全消失。外周前庭功能缺损也可能引发晕厥发作，必须通过全面的听力学和前庭评估来加以考虑和研究。通过前庭治疗恢复右侧迷路的外周前庭功能后，观察到多次血管迷走性晕厥发作得到长期完全缓解，同时倾斜试验恢复正常。
