Original Paper

Combined Transcranial Doppler and EEG Recording in Vasovagal Syncope
E. Vicenzini^a, S. Pro^a, S. Strano^b, P. Pulitano^a, M. Altieri^a, V. Di Piero^a, G.L. Lenzi^a, N. Accornero^a, O. Mecarelli^a

Departments of
^aNeurological Sciences and
^bCardiovascular and Respiratory Sciences, University of Rome, 'La Sapienza', Rome, Italy

Address of Corresponding Author

Eur Neurol 2008;60:258-263 (DOI: 10.1159/000151702)

  Key Words

• Syncope
• Transcranial Doppler
• Quantitative EEG
• Cerebral vasoreactivity

  Abstract

Background: In neurally mediated syncope a 'typical' EEG pattern during hyperventilation (HV) may be observed. This study aimed to investigate transcranial Doppler (TCD) and EEG variations in response to hyper- and hypocapnia using simultaneous recording. Methods: Syncope patients with a typical EEG pattern during HV (SEEG+, n = 15) and those without abnormalities (SEEG-, n = 16) were compared with healthy controls (n = 20). Simultaneous TCD and EEG recordings were performed at rest (baseline), during 2 apnea tests and during HV. Cerebrovascular vasoreactivity, index for hypocapnia, total vasomotor reserve and time to flow velocity normalization after HV (t-norm) were recorded. Results: With TCD, a reduction in Vasomotor reserve was observed in SEEG+ compared with the other 2 groups (control: 67 ± 8%; SEEG-: 67 ± 10%; SEEG+: 57 ± 8%; p < 0.0001). t-norm was longer in all syncopal patients and in particular in SEEG+ (control: 20.2 ± 3 s; SEEG-: 40 ± 7 s; SEEG+: 123 ± 45s; p < 0.0001). Quantitative EEG showed an increase in slow bands in all subjects during HV, small and nonsignificant in controls and SEEG-, higher and significant in SEEG+, related with flow reduction. Conclusions: Changes in the sympathetic modulation of cerebral vasoconstriction may explain both the pathophysiology of vasovagal syncope and the typical paroxysmal EEG findings.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Edoardo Vicenzini
Department of Neurological Sciences, University of Rome, 'La Sapienza'
Viale dell'Università 30
IT-00185 Rome (Italy)
Tel. +39 06 4991 4705, Fax +39 06 4991 4194, E-Mail edoardo.vicenzini@uniroma1.it

  Article Information

Received: December 28, 2007
Accepted: March 17, 2008
Published online: August 29, 2008
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 1, Number of References : 14