A case of swallowing syncope with an esophageal tumor

J Korean Neurol Assoc > Volume 15(4); 1997 > Article

Journal of the Korean Neurological Association 1997;15(4): 921-925.

식도 종양을 동반한 연하실신 1례

송영목, 조용진, 노재규

서울대학교 의대 신경과

A case of swallowing syncope with an esophageal tumor

Young-Mok Song, M.D., Yong-Jin Cho, M.D., Jae-Kyu Roh, M.D.

Department of Neurology,k College of Medicine, Seoul National University Hospital

Abstract

Swallowing is a rare cause of syncope. In swallowing syncope, loss of consciousness occurs during or immediately after a swallow. It is mediated via an esophagocardiac vagal reflex arc. The efferent impulse originates in the esophageal sensory endings of the vagus nerve and from the dorsal vagal nucleus an efferent vagus nerve to the heart cause bradycardia or varying degrees of heart block. Bradycardia or heart block in response to swallowing produces decreased cardiac output and results in cerebral hypoperfusion and loss of consciousness. It is occasionally associated with the esophageal or heart disease. The esophageal or heart disease may exaggerate the reflex. We report a patient who had loss of consciousness during swallowig and had a esoophageal submucosal tumor. In EKG monitoring a swallowing induced sinoatrial black was found.