Three Case of Dizziness Due to Vasovagal Reflex

• Published in: Equilibrium Research Vol. 57; no. 3; pp. 297 - 304
• Main Authors: Masaki, Yoshio, Watanabe, Michitaka, Furukawa, Tomoyasu, Kano, Akihiko, Yamatani, Chiemi
• Format: Journal Article
• Language: English; Japanese
• Published: Japan Society for Equilibrium Research 1998
• Subjects: autonomic nervous system; dizziness; Head up tilt test; vasovagal reflex
• ISSN: 0385-5716; 1882-577X
• DOI: 10.3757/jser.57.297

Introduction Vasovagal reflex (VVR) is a disease that has received attention in various fields. Recently, researchers have started to clarify its mechanism. Three patients with symptoms probably due to VVR were treated in this department and the Head up tilt test was used to diagnose dizziness due to VVR. Patients The three patients included a 21-year-old female (Case 1), a 26-year-old male (Case 2) and a 61-year-old female (Case 3). All three patients had chief complaints of spontaneous dizziness after standing or sitting for 5 to 30 minutes. Results The duration of standing before the onset of positive findings was 9.5 minutes in Case 1 and 11 minutes in Case 2. In Case 3, positive findings were obtained 9.5 minutes after isoproterenol administration. Discussion All three patients showed spontaneous dizziness in either the standing or sitting position and the results of the Head up tilt test were positive. Therefore, dizziness seemed to be due to VVR in these patients. The instantaneous decrease in blood volume due to paradoxical activation of the vagus nerve may have induced dizziness, loss of consciousness and faintness. Because of severe patient stress during the Head up tilt test, this examination should be indicated only in those who are strongly suspected of VVR.