Clinical neuromythology XV. Feinting science: Neurocardiogenic syncope and collateral vasovagal confusion

MCM: A sarcastic critique of the diagnosis of neurocardiogenic

syncope and the costly workup currently advocated including

tilt table testing. Reviews history of diagnosis of syncope,

and laments the replacement of “vasovagal” with

“neurocardiogenic”. Isoporoterenol is a vasodilator and can

independently cause cerebral hypoperfusion and syncope. Tilt

table testing has not satisfactorily differentiated fainters

from nonfainters, there is no standard protocol, and it has

poor reproducibility. The psychiatrist ultimately ascertains

the [true] medical history, diagnosing drug effects, panic,

somatization, hyperventilation, depression, malingering,

hysterias/somatization, Briquet’s S.

Landau WM, Nelson DA

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