Neurally mediated syncope

Neurally mediated syncope is a disorder of the autonomic regulation of post ural tone, which results in hypotension, bradycardia, and loss of conscious ness A wide variety of stimuli can trigger this reflex, the most common sti mulus being orthostatic stress. Typically, a patient with neurally mediated syncope experiences nausea, lightheadedness, a feeling of warmth, and pall or before abruptly losing consciousness. If the cause of syncope is unclear , a stepwise approach is necessary to arrive at the diagnosis. The diagnosi s of neurally mediated syncope can be confirmed by a head-up tilt-table tes t. Treatment options include behavioral modification and several pharmacolo gic therapies. For severe recurrent syncope unresponsive to conventional tr eatment, a pacemaker can be implanted.