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ASSOCIATION OF CAROTID SINUS REFLEXES WITH SYNCOPE AND CONVULSIONS: REPORT OF FOUR CASES

ASSOCIATION OF CAROTID SINUS REFLEXES WITH SYNCOPE AND CONVULSIONS: REPORT OF FOUR CASES Abstract Since the work of Hering in 1923 on the reflex control of the heart rate and the vasomotor system, there has arisen a new interest in a subject which has occupied clinicians for many years. In 1799 Parry,1 in the course of a study on angina pectoris, noted that pressure on the neck slows the rate of the heart. Czermak2 in 1866 observed in himself that pressure on an expansile body at the upper border of the sternocleidomastoid muscle resulted in retardation of the pulse. He thought that this effect was due to mechanical excitation of the vagus nerve. For many years clinicians accepted this explanation, even though a great deal of experimental work tended to disprove Czermak's conception. Pagano3 in 1900 conducted experiments to show that the changes in the heart rate and vasomotor tonus produced by arterial hypotension or hypertension in the cerebral circulation are References 1. Parry, C. H.: An Inquiry into the Symptoms and Causes of the Syncope Anginosa, Commonly Called Angina Pectoris , London, Cadell & Davis, 1799, p. 167. 2. Czermak, Joseph: Mechanical Irritation of the Vagus Nerve in Man , Jenaische Ztschr. f. Med. u. Naturw. 2:384, 1866. 3. Pagano, in Heymans, C.; Bouckaert, J. J., and Regniers, P.: Le sinus carotidién et la zone homologue cardio-aortique , Paris, Gaston Doin & Cie, 1933. 4. Siciliano, in Heymans, C.; Bouckaert, J. J., and Regniers, P.: Le sinus carotidién et la zone homologue cardio-aortique , Paris, Gaston Doin & Cie, 1933. 5. Sollmann, T., and Brown, E. D.: The Blood Pressure Fall Produced by Traction on the Carotid Artery , Am. J. Physiol. 30:88, 1912. 6. Hering, H. E.: Experiments with Pressure on the Carotid Sinus , München. med. Wchnschr. 70:1287, 1923. 7. Koch, E.: Clinical Observations in Cases of Pressure on the Carotid Sinus , München. med. Wchnschr. 70:1316, 1923. 8. Blanton, H. W., and Blanton, W. B.: Cardiac Standstill with Syncope Following Pressure on Right Vagus , J. A. M. A. 76:1220 ( (April 30) ) 1921.Crossref 9. Budde, M.: Surgical Experiences with Carotid Sinus Pressure Experiments , Ztschr. f. d. ges. exper. Med. 50:207, 1926. 10. Roskam, Jacques: A New Syndrome, Severe Cardiac Syncopes and Repeated Syncopes Due to Hyperreflexia of the Carotid Sinus , Presse méd. 38: 590 ( (April 30) ) 1930. 11. Weiss, S., and Baker, J. P.: The Carotid Sinus Reflex in Health and Disease , Medicine 12:297, 1933.Crossref 12. Ferris, E. B., Jr.; Capps, R. B., and Weiss, S.: Carotid Sinus Syncope and Its Bearing on the Mechanism of the Unconscious State and Convulsions , Medicine 14:377, 1935.Crossref 13. Moses, H. M., and Feinstein, S. S.: Reflex Hypersensitivity of the Carotid Sinus , Ann. Int. Med. 8:1413, 1935.Crossref 14. Smith, H. L., and Moersch, F. P.: Syncope of Patients with Hypersensitive Carotid Reflexes: Attacks Reproduced by Cardiac Standstill Induced by Pressure on Carotid Sinus , Proc. Staff Meet., Mayo Clin. 10:401 ( (June 26) ) 1935. 15. Weiss and Baker.11 16. Ferris, Capps and Weiss.12 17. Moses and Feinstein.13 18. Smith and Moersch.14 19. We have seen eight additional cases, all similar to case 2, of the cardiac type. Two of the patients had the initial attack of syncope and convulsions after a surgical procedure—one, after removal of a specimen from the thyroid for biopsy, and the other, after a gynecological operation. The others had had attacks of syncope and convulsions for varying periods. 20. Schwartz, S. P.: Transient Ventricular Fibrillation , Arch. Int. Med. 49:282 ( (Feb.) ) 1932Crossref 21. 50:450 (Sept.) 1932. 22. Willius, F. A.: Clinic on Paroxysmal Tachycardia (Nodal Type), Pulmonary Tuberculosis and Thoracoplasty , Proc. Staff Meet., Mayo Clin. 10: 759 ( (Nov. 27) ) 1935. 23. Weiss, S.; Ferris, E. B., Jr., and Capps, R. B.: Influence of Reflexes in the Induction of Intracardiac Disturbances , Tr. A. Am. Physicians 49:177, 1934. 24. Lennox, W. G.; Gibbs, F. A., and Gibbs, E. L.: Relationship of Unconsciousness to Cerebral Blood Flow and to Anoxemia , Arch. Neurol. & Psychiat. 34:1001 ( (Nov.) ) 1935. 25. Bradbury, S., and Eggleston, C.: Postural Hypotension , Am. Heart J. 3:105, 1927. 26. Laubry, C., and Doumer, E.: Orthostatic Hypotension , Presse méd. 40:17 ( (Jan. 6) ) 1932. 27. Ganshorn, J. A., and Horton, B. T.: Postural Hypotension: Report of a Case , Proc. Staff Meet., Mayo Clin. 9:541 ( (Sept. 12) ) 1934. 28. Ghrist, David G., and Brown, George E.: Postural Hypotension with Syncope: Its Successful Treatment with Ephedrin , Am. J. M. Sc. 175:336, 1928. 29. Weis, Clifford R.: Postural Hypotension with Syncope: Report of a Case Cured with Ephedrin Sulphate , Ann. Int. Med. 8:920, 1935. 30. Kirklin, O. L.: Obstruction of the Right Innominate and Left Subclavian Arteries with Orthostatic Syncope , Proc. Staff Meet., Mayo Clin. 10:673 ( (Oct. 23) ) 1935. 31. Heymans, C.; Bouckaert, J. J., and Dautrebande, L.: The Reflex Regulation of the Circulation by the Vasosensory Nerves of the Sinus Caroticus , Arch. internat. de pharmacodyn. et de thérap. 40:292, 1931. 32. Urban, H.: Carotid Sinus Reflex in Man , Deutsche med. Wchnschr. 61: 1597 ( (Oct. 4) ) 1935.Crossref 33. Lewis, T.: Vasovagal Syncope and Carotid Sinus Mechanism, with Comments on Gowers and Nothnagel's Syndrome , Brit. M. J. 1:873 ( (May 14) ) 1932.Crossref 34. Leriche, R.; Fontaine, R., and Froelich, F.: The Question of Permissibility of Denervation of the Carotid Sinus from the Physiologic Point of View , Presse méd. 43:1217 ( (July 31) ) 1935. 35. Green, M. F., and Degroat, A.: Observations of the Late Effects of Denervation of the Carotid Sinuses and Section of the Depressor Nerves , Am. J. Physiol. 112:488, 1935. 36. Green, M. F.; Degroat, A., and McDonald, C. H.: Observations on Denervation of the Carotid Sinuses and Section of the Depressor Nerves as a Method of Producing Arterial Hypertension , Am. J. Physiol. 110:513, 1935. 37. Danielopolu, D., and Aslan, A.: Continued Effect of Sinocarotid Neurectomy on the Heart Rhythm and the Blood Pressure in Man , Ztschr. f. klin. Med. 120:237, 1932. 38. Bucy, Paul: Carotid Sinus Nerve in Man , Arch. Int. Med. 58:418 ( (Sept.) ) 1936.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology & Psychiatry American Medical Association

ASSOCIATION OF CAROTID SINUS REFLEXES WITH SYNCOPE AND CONVULSIONS: REPORT OF FOUR CASES

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American Medical Association
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Copyright © 1937 American Medical Association. All Rights Reserved.
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0096-6754
DOI
10.1001/archneurpsyc.1937.02260220105006
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Abstract

Abstract Since the work of Hering in 1923 on the reflex control of the heart rate and the vasomotor system, there has arisen a new interest in a subject which has occupied clinicians for many years. In 1799 Parry,1 in the course of a study on angina pectoris, noted that pressure on the neck slows the rate of the heart. Czermak2 in 1866 observed in himself that pressure on an expansile body at the upper border of the sternocleidomastoid muscle resulted in retardation of the pulse. He thought that this effect was due to mechanical excitation of the vagus nerve. For many years clinicians accepted this explanation, even though a great deal of experimental work tended to disprove Czermak's conception. Pagano3 in 1900 conducted experiments to show that the changes in the heart rate and vasomotor tonus produced by arterial hypotension or hypertension in the cerebral circulation are References 1. Parry, C. H.: An Inquiry into the Symptoms and Causes of the Syncope Anginosa, Commonly Called Angina Pectoris , London, Cadell & Davis, 1799, p. 167. 2. Czermak, Joseph: Mechanical Irritation of the Vagus Nerve in Man , Jenaische Ztschr. f. Med. u. Naturw. 2:384, 1866. 3. Pagano, in Heymans, C.; Bouckaert, J. J., and Regniers, P.: Le sinus carotidién et la zone homologue cardio-aortique , Paris, Gaston Doin & Cie, 1933. 4. Siciliano, in Heymans, C.; Bouckaert, J. J., and Regniers, P.: Le sinus carotidién et la zone homologue cardio-aortique , Paris, Gaston Doin & Cie, 1933. 5. Sollmann, T., and Brown, E. D.: The Blood Pressure Fall Produced by Traction on the Carotid Artery , Am. J. Physiol. 30:88, 1912. 6. Hering, H. E.: Experiments with Pressure on the Carotid Sinus , München. med. Wchnschr. 70:1287, 1923. 7. Koch, E.: Clinical Observations in Cases of Pressure on the Carotid Sinus , München. med. Wchnschr. 70:1316, 1923. 8. Blanton, H. W., and Blanton, W. B.: Cardiac Standstill with Syncope Following Pressure on Right Vagus , J. A. M. A. 76:1220 ( (April 30) ) 1921.Crossref 9. Budde, M.: Surgical Experiences with Carotid Sinus Pressure Experiments , Ztschr. f. d. ges. exper. Med. 50:207, 1926. 10. Roskam, Jacques: A New Syndrome, Severe Cardiac Syncopes and Repeated Syncopes Due to Hyperreflexia of the Carotid Sinus , Presse méd. 38: 590 ( (April 30) ) 1930. 11. Weiss, S., and Baker, J. P.: The Carotid Sinus Reflex in Health and Disease , Medicine 12:297, 1933.Crossref 12. Ferris, E. B., Jr.; Capps, R. B., and Weiss, S.: Carotid Sinus Syncope and Its Bearing on the Mechanism of the Unconscious State and Convulsions , Medicine 14:377, 1935.Crossref 13. Moses, H. M., and Feinstein, S. S.: Reflex Hypersensitivity of the Carotid Sinus , Ann. Int. Med. 8:1413, 1935.Crossref 14. Smith, H. L., and Moersch, F. P.: Syncope of Patients with Hypersensitive Carotid Reflexes: Attacks Reproduced by Cardiac Standstill Induced by Pressure on Carotid Sinus , Proc. Staff Meet., Mayo Clin. 10:401 ( (June 26) ) 1935. 15. Weiss and Baker.11 16. Ferris, Capps and Weiss.12 17. Moses and Feinstein.13 18. Smith and Moersch.14 19. We have seen eight additional cases, all similar to case 2, of the cardiac type. Two of the patients had the initial attack of syncope and convulsions after a surgical procedure—one, after removal of a specimen from the thyroid for biopsy, and the other, after a gynecological operation. The others had had attacks of syncope and convulsions for varying periods. 20. Schwartz, S. P.: Transient Ventricular Fibrillation , Arch. Int. Med. 49:282 ( (Feb.) ) 1932Crossref 21. 50:450 (Sept.) 1932. 22. Willius, F. A.: Clinic on Paroxysmal Tachycardia (Nodal Type), Pulmonary Tuberculosis and Thoracoplasty , Proc. Staff Meet., Mayo Clin. 10: 759 ( (Nov. 27) ) 1935. 23. Weiss, S.; Ferris, E. B., Jr., and Capps, R. B.: Influence of Reflexes in the Induction of Intracardiac Disturbances , Tr. A. Am. Physicians 49:177, 1934. 24. Lennox, W. G.; Gibbs, F. A., and Gibbs, E. L.: Relationship of Unconsciousness to Cerebral Blood Flow and to Anoxemia , Arch. Neurol. & Psychiat. 34:1001 ( (Nov.) ) 1935. 25. Bradbury, S., and Eggleston, C.: Postural Hypotension , Am. Heart J. 3:105, 1927. 26. Laubry, C., and Doumer, E.: Orthostatic Hypotension , Presse méd. 40:17 ( (Jan. 6) ) 1932. 27. Ganshorn, J. A., and Horton, B. T.: Postural Hypotension: Report of a Case , Proc. Staff Meet., Mayo Clin. 9:541 ( (Sept. 12) ) 1934. 28. Ghrist, David G., and Brown, George E.: Postural Hypotension with Syncope: Its Successful Treatment with Ephedrin , Am. J. M. Sc. 175:336, 1928. 29. Weis, Clifford R.: Postural Hypotension with Syncope: Report of a Case Cured with Ephedrin Sulphate , Ann. Int. Med. 8:920, 1935. 30. Kirklin, O. L.: Obstruction of the Right Innominate and Left Subclavian Arteries with Orthostatic Syncope , Proc. Staff Meet., Mayo Clin. 10:673 ( (Oct. 23) ) 1935. 31. Heymans, C.; Bouckaert, J. J., and Dautrebande, L.: The Reflex Regulation of the Circulation by the Vasosensory Nerves of the Sinus Caroticus , Arch. internat. de pharmacodyn. et de thérap. 40:292, 1931. 32. Urban, H.: Carotid Sinus Reflex in Man , Deutsche med. Wchnschr. 61: 1597 ( (Oct. 4) ) 1935.Crossref 33. Lewis, T.: Vasovagal Syncope and Carotid Sinus Mechanism, with Comments on Gowers and Nothnagel's Syndrome , Brit. M. J. 1:873 ( (May 14) ) 1932.Crossref 34. Leriche, R.; Fontaine, R., and Froelich, F.: The Question of Permissibility of Denervation of the Carotid Sinus from the Physiologic Point of View , Presse méd. 43:1217 ( (July 31) ) 1935. 35. Green, M. F., and Degroat, A.: Observations of the Late Effects of Denervation of the Carotid Sinuses and Section of the Depressor Nerves , Am. J. Physiol. 112:488, 1935. 36. Green, M. F.; Degroat, A., and McDonald, C. H.: Observations on Denervation of the Carotid Sinuses and Section of the Depressor Nerves as a Method of Producing Arterial Hypertension , Am. J. Physiol. 110:513, 1935. 37. Danielopolu, D., and Aslan, A.: Continued Effect of Sinocarotid Neurectomy on the Heart Rhythm and the Blood Pressure in Man , Ztschr. f. klin. Med. 120:237, 1932. 38. Bucy, Paul: Carotid Sinus Nerve in Man , Arch. Int. Med. 58:418 ( (Sept.) ) 1936.Crossref

Journal

Archives of Neurology & PsychiatryAmerican Medical Association

Published: Oct 1, 1937

References