Case Report Cardiac Syncope Induced by Glossopharyngeal “Neuralgia”: a Rare Presentation

fascicular block (LAFB); Gastrointestinal endoscopy- distal esophagitis and erosive gastritis; Videofluoroscopic swallowing studies – stasis of residual food in the vallecular region. • Loop event monitoring – sinus arrest and asystole lasting 4.4 seconds, associated with reporting of presyncope during lunch (Fig 1) Following the diagnosis of swallow-induced syncope with cardiac asystole, the patient underwent permanent pacemaker implantation, and since that time has remained free of syncopal episodes (thirty-five months of follow-up). Patient with fainting spells related to liquid intake without pain on swallowing over a period of several months. He underwent loop event monitoring, which demonstrated prolonged sinus pause with asystole during swallowing. Syncopal episodes were therefore justified by low cerebral blood flow associated with glossopharyngeal nerve stimulation, even in the absence of pain that characterizes this condition. In cases of glossopharyngeal “neuralgia” without severe pain, permanent cardiac pacing is suggested as early treatment. To our knowledge, this is the first such case reported in Brazilian literature. Case report A 71-year-old white male patient complaining of sporadic syncopal episodes lasting for a few seconds upon drinking liquids. When questioned, he reported mild, ill-characterized “spasms ” in the throat on these occasions. In one of these episodes, he fell and broke a lumbar vertebra. The patient was taking antiparkinsonian drugs regularly