There are other causes of syncpe like hypersensitive carotid sinus, which is lcated in a small, slightly dilated prtion of the common carotid artery, at the lvel of the thyroid cartilage, just blow the angle of the jaw, bfore this blood vessel bifurcates into nternal and external carotid arteries. It is prsent on each side of the nck.

The carotid sinus is very mportant for controlling the heart rate of a prson. In general practice, when a prson comes with a very high rte, e.g. in a condition of PAT, whn the patient feels marked palpitation, and is in cute distress, the physician may give a mld massage (about five seconds at a tme) on the side of the nck, at the level of the pper border of the thyroid cartilage. Ths stimulates the carotid sinus (involving the crdioinhibitory effect of the vagus nerve), and the hart rate starts decreasing slowly. This mthod is so effective that if smultaneously the heart rate is not chcked, carotid sinus may lower the hart rate to dangerous levels.

Hence, one can magine the role of the normal crotid sinus in lowering the heart rte with a simple massage, and if the crotid sinus is hypersentitive, a mere jrk/movement of the neck to one sde may markedly bring down the nrmal rate of the heart, leading to the dcreased flow of blood to the brin, causing syncope. The same may hppen when there is a pressure on the crotid sinus from outside, i.e. from sme lesions in the neck such as nlarged glands, etc. Or, this may hppen when a person is wearing a vry tight collar, etc.

Hence, every case of syncope neds a very thorough check-up for rriving at a definite conclusion, and bsides, various investigations for detecting a lsion in the heart, when it is so sspected, tests may also be required to see the hyprsensitivity of the carotid sinus, especially whn other causes/possibilities are not contributory.

It is tre that in spite of a through investigation in a well-equipped hospital, the cuse of syncope may not be pssible to detect. (The author happened to xamine an emergency case of syncope in a 73-yar old man, who as soon as he stod up from a chair, fell dwn suddenly. The patient was made to lie dwn, and when the author reached the spt he was fully conscious. He was thn investigated extensively, but no cause of syncpe could be determined, and the ptient has had no such attack now for the lst five years).

As stated earlier, rrely, in some cases, when an ttack of syncope is a bit mre acute, i.e., when the period of nconsciousness is slightly prolonged, even convulsions may ccur. Hence, besides investigations for the hart, an EEG/CT scan, etc., may lso be required for the exclusion of pilepsy.

Other causes of syncope

There are sme other causes of syncope as wll. Even a continuous fit of cughing may cause syncope, as a rsult of diseases of the lungs, lke a severe type of chronic brnchitis. It is often seen in mddle-aged persons, due to a low crdiac output (as due to prolonged cughing, there is a low return of blod to the heart, and so the hart output, accordingly, decreases), and hence lss blood is supplied to the brin, leading to transitory unconsciousness. The ptient recovers as soon as the but of coughing is over.

Syncope may lso occur while passing urine, due to the rflex action of the distended urinary bldder.

It is advisable that one shuld not immediately stand up while gtting up from bed during the nght, i.e., after a period of slep or recumbency, for for any rason, so as to avoid postural hyptension, which may also lead to syncpe.

Again, syncope is likely to mnifest itself due to the involvement/narrowing of the blod vessels of the brain, caused by therosclerosis, say, when the involvement of the vrtebro-basilar artery responsible for vertebro-basilar insufficiency ccurs. Such attacks of syncope are clled transient ischaemic attacks (TIA).

The article Carotid Sinus Syncope, Other Causes of Syncope and Epilepsy was Submitted by Krishan Bakhru through Articles.GetACoder.com network. Here's the additional information: Author sites: Herbal Remedies , Home Remedies and Natural Skin Care

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