Syncope accounts for almost 40% of patients who come to a clinic complaining of “sudden fall episodes”. It is a transient loss of consciousness associated with a loss of body tone. Most patients recover spontaneously. It can occur as a single event without any specific causation or can also be recurrent when associated with organic pathology. The basic pathophysiology includes decreased cerebral blood flow.
An occurrence of syncope should be differentiated from a seizure episode, as it mimics the latter very closely. Recurrent, unexplained episodes of syncope should be investigated for possible structural cardiac pathologies, as they can lead to death if not treated in time. Most of the time, syncope occurs suddenly without any warning, but few patients may experience pre-syncope manifestations like dizziness, lightheadedness, feeling hot, nausea, and visual blurring.
Cause :
The transient reduction in cerebral blood flow is mainly due to three basic causes
1. Disturbance in vascular tone or blood volume
2. Obstructive Cardiovascular Disorders and Rhythm Abnormalities
3. Cerebrovascular diseases
Disturbance in vascular tone or blood volume may be due to conditions such as coughing, urination, defecation, or Valsalva maneuver as well as carotid sinus hypersensitivity. Also due to orthostatic hypotension due to certain vasodilator drugs, pure autonomic failure, peripheral neuropathy and decreased blood volume. Heart rhythm abnormalities such as sinus bradicardia, sinus arrest, atrioventricular block, or atrial flutter and fibrillation can also lead to syncope. Vetebrobasilar insufficiency or basilar migraine is one of the cerebrovascular diseases that cause syncope.
Disorders that can mimic syncope are a few metabolic disorders like hypoxia, hypoglycemia, anemia, or hyperventilation or certain psychogenic events due to panic attacks or hysterical fainting.
Neurocardiogenic or vasovagal syncope is usually associated with both sympathetic withdrawal (vasodilation) and increased parasympathetic activity causing bradicardia. These are precipitated by alcohol consumption, severe pain, extreme fatigue, hunger, prolonged standing, exposure to a hot or crowded environment, and during an emotional situation.
Diagnostic:
The pathologies mentioned above should be excluded by carrying out diagnostic tests after a thorough clinical history – including serum electrolytes, glucose and blood count. Electrocardiogram, cardiac enzymes should be checked in case of cardiac causes. An electroencephalogram will rule out the possibility of seizure activity.
Homeopathic treatment:
Syncope attacks occurring sporadically do not require any treatment if you diagnose them of vasovagal origin. Remedies such as gelsemium, belladonna, conium, and phosphorus have been most effective in treating intermittent syncope episodes.
