• Acta Medica Port · Nov 2024

    Recurrent Syncope During Migraine Attacks.

    • Mariana Dias da Costa, Beatriz Nunes Vicente, Dourado SoteroFilipaFService of Neurology. Department of Neurosciences and Mental Health. Hospital de Santa Maria. Unidade Local de Saúde Santa Maria. Lisbon; Centro de Estudos Egas Moniz. Faculdade de Medicina. Universidade de Lisboa. Lisbon; Faculty of , and Pavão MartinsIsabelIService of Neurology. Department of Neurosciences and Mental Health. Hospital de Santa Maria. Unidade Local de Saúde Santa Maria. Lisbon; Centro de Estudos Egas Moniz. Faculdade de Medicina. Universidade de Lisboa. Lisbon; Faculty of M.
    • Service of Neurology. Department of Neurosciences and Mental Health. Hospital de Santa Maria. Unidade Local de Saúde Santa Maria. Lisbon. Portugal.
    • Acta Medica Port. 2024 Nov 28.

    AbstractMigraine is a cyclic condition with attacks consisting mainly of intense headaches, sensory intolerance, and nausea or vomiting. Loss of consciousness during attacks is often attributed exclusively to a neurally mediated reflex to pain, although it may also be due to migraine's autonomic impairment, with cardiac conduction abnormalities, probably in relation to a degree of reduced sympathetic function. We report the case of a 51-year-old woman presenting episodes of syncope exclusively after vomiting during migraine attacks. A 24-hour Holter monitoring performed during a migraine attack disclosed an intermittent complete atrioventricular block coincident with an episode of syncope. The patient was implanted with a pacemaker without further syncopes on subsequent attacks. This case highlights the importance of clinical suspicion and investigation of syncope during migraine attacks. Recurrent syncope during migraine should not be attributed to pain to avoid misdiagnosis and ensure the treatment of other important causes of syncope.

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