Dykman T R, Montgomery E B, Gerstenberger P D, Zeiger H E, Clutter W E, Cryer P E
Am J Med. 1981 Jul;71(1):165-70. doi: 10.1016/0002-9343(81)90287-4.
A patient with metastatic laryngeal carcinoma had glossopharyngeal neuralgia and syncope due to hypotension and bradycardia. Treatment of bradyarrhythmias failed to prevent hypotension. The administration of carbamazepine failed to prevent pain or syncope in this patient despite previous reports of success. Symptoms did resolve with intracranial section of the glossopharyngeal nerve and the upper two rootlets of the vagus. Plasma catecholamines were studied during a hypotensive episode. The values obtained demonstrated a suppressed sympathetic adrenergic neural response but an intact adrenomedullary response, suggesting that suppression of adrenergic vasoconstriction contributed to episodes of hypotension. The administration of intravenous atropine produced a transient increase in blood pressure suggesting that, in the presence of suppressed adrenergic vasoconstriction, cholinergic vasodilation may have contributed to the hypotension in this patient.
一名转移性喉癌患者出现了舌咽神经痛以及因低血压和心动过缓导致的晕厥。治疗缓慢性心律失常未能预防低血压。尽管之前有成功的报道，但给予卡马西平未能预防该患者的疼痛或晕厥。症状在进行舌咽神经及迷走神经上两个神经根的颅内切断术后得以缓解。在一次低血压发作期间对血浆儿茶酚胺进行了研究。所获得的值显示交感肾上腺素能神经反应受到抑制，但肾上腺髓质反应完好，这表明肾上腺素能血管收缩的抑制导致了低血压发作。静脉注射阿托品使血压出现短暂升高，这表明在肾上腺素能血管收缩受到抑制的情况下，胆碱能血管舒张可能导致了该患者的低血压。
