Traumaandsyncope-evidenceforfurthersleepstudy?Acasereport
摘要: Wereportonan83-year-oldmalewithtraumaticbraininjuryaftersyncopewithafallinthemorning.Hehadahistoryofseizures,coronaryarterydiseaseandparoxysmalatrialfibrillation(AF).Nomedicalcauseforseizuresandsyncopewasdetermined.Duringrehabilitation,thepatientstillcomplainedofseizures,andalsoreportedsleepinessandsnoring.Sleepapneadiagnosticsrevealedobstructivesleepapnea(SA)withanapnea-hypopnoeaindexof35/h,andsuddenonsetoftachycardiawithvariationsofheartratebasedonparoxysmalatrialfibrillation.AdditionaltestsshowednocturnalAFwhichspontaneouslyconvertedtosinusrhythmmid-morningwithanarrestof5s(sicksinussyndrome)andseizures.ADDD-pacerwasimplantedandnofurtherseizuresoccurred.SAtherapywithnasalcontinuouspositiveairwaypressurewasrefusedbythepatient.OurfindingssuggeststhatscreeningforSAmayofferthepossibilitytorevealcausesofsyncopeandmayintroduceadditionaltherapeuticoptionsasarrhythmiaandSAoftenoccurtogetherwhichinturnmightberesponsiblefortraumaduetosyncopeepisodes. ...
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