Neurally mediated syncope presenting with paroxysmal positional vertigo and tinnitus

Fumiyuki Goto, Tomoko Tsutsumi, Iwao Nakamura, Kaoru Ogawa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


A 72-year-old man with positional vertigo and tinnitus was referred to us. He did not want to perform provoking test except once due to his fear. No positional nystagmus was provoked. He found that his attacks usually occurred when he lay on his right ear. From his clinical history, benign paroxysmal positional vertigo was suspected. Conventional pharmacotherapy as well as non-specific physical therapy did not have significant effect. His feeling of positional vertigo with pyrosis was actually presyncope. We suspected cardiovascular disorders, and referred him to a cardiologist. Portable cardiogram monitoring revealed paroxysmal bradycardia. He was diagnosed with neurally mediated syncope, and a pacemaker was implanted. His paroxysmal dizziness soon disappeared. It is important to study the clinical history of the patients in detail, as they are not always able to accurately explain their symptoms. We should carefully rule out cardiovascular disorders, especially when we see the patients with suspected BPPV without the characteristic positional nystagmus.

Original languageEnglish
Pages (from-to)531-533
Number of pages3
JournalAuris Nasus Larynx
Issue number5
Publication statusPublished - 2012 Oct


  • Cardiovascular
  • Positional vertigo
  • Syncope
  • Vestibular

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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