What are the causes of neurogenic syncope?

Generally, neurogenic syncope may be caused by factors such as postural changes, sudden cessation after strenuous exercise, hypoglycemia, arrhythmia, and hypertensive encephalopathy. Symptomatic management usually involves general treatment and medication. If physical discomfort occurs, prompt medical attention is advised. Detailed analysis is as follows:

1. Postural Changes

When body posture suddenly changes, such as rising quickly from a seated or lying position, it may temporarily reduce blood supply to the brain, leading to syncope. It is recommended to rise slowly from lying or squatting positions to reduce the occurrence of orthostatic hypotension.

2. Sudden Cessation After Strenuous Exercise

During intense exercise, blood circulation accelerates, with most blood flowing to the limb muscles. If exercise stops suddenly, blood may pool in the leg vessels, reducing venous return and causing cerebral hypoperfusion, which can lead to syncope. After intense exercise, it is recommended to perform appropriate cool-down activities, such as jogging, walking, or simple stretching exercises, to help the body transition smoothly from an active to a resting state.

3. Hypoglycemia

Hypoglycemia is mainly caused by insufficient food intake or excessive glucose-lowering treatment. The brain relies on glucose as an energy source; when glucose levels are low, the brain's energy supply is insufficient, potentially causing syncope accompanied by typical symptoms such as sweating, tremors, hunger, and palpitations. It is recommended to use medications such as glucose and sodium chloride injection, hydrocortisone tablets, and mannitol injection under medical guidance to rapidly increase blood glucose levels.

4. Arrhythmia

Abnormal cardiac electrophysiology or cardiovascular diseases may cause arrhythmia, during which the heart cannot pump blood normally, leading to insufficient cerebral blood supply. Patients may experience dizziness, nausea, vomiting, and in severe cases, loss of consciousness. Accompanying symptoms may include palpitations, chest tightness, and shortness of breath. It is recommended to follow medical advice and use medications such as atropine sulfate injection, metoprolol tartrate tablets, and phenytoin sodium tablets to alleviate symptoms.

5. Hypertensive Encephalopathy

Hypertensive encephalopathy is a condition where a sudden sharp increase in blood pressure causes cerebral circulation disturbances. This condition can lead to cerebral tissue ischemia and hypoxia, causing syncope, along with symptoms such as headache, nausea, and vomiting. In severe cases, loss of consciousness may occur. It is recommended to use medications such as urapidil hydrochloride injection, sodium nitroprusside injection, and mannitol injection under medical supervision for treatment.

In daily life, it is recommended to ensure sufficient sleep each day, allowing the body and brain adequate rest and recovery.

References

[1] Shi Zhisen. Clinical value of head CT scan in patients with syncope in emergency [J]. Chinese Medical Device Information, 2019, 25(08):146-147.

[2] Wang Kun, Liu Zhu. Clinical analysis of syncope in the elderly [J]. Huaihai Medicine, 2014, 32(02):149-150.