Hello and welcome to the Zero to Finals podcast. My name is Tom, and in this episode, I'm going to be talking to you about Syncope.

And if you want to follow along with written notes on this topic, you can follow along at Zerodefinals.com slash Syncope,

or in the neurology section of the zero to finals pediatrics book.

So let's get straight into it.

When the vagus nerve receives a strong stimulus,

such as an emotional event, a painful sensation, or a change in temperature,

it can stimulate the parasympathetic nervous system.

Parasympathetic activation counteracts the sympathetic nervous system,

and it's the sympathetic nervous system which is responsible for keeping the smooth

muscles in blood vessels constricted.

As the blood vessels delivering blood to the brain relax, the blood pressure in the cerebral circulation

drops leading to hypopo-perusion of the brain tissue. This causes the patient to lose consciousness

and faint. Let's talk about the signs and symptoms.

Patients often remember the event and can recall how they felt prior to fainting.

This is called the Prodrome and it involves feeling hot and clammy,

sweaty, heavy, dizzy or lightheaded, having the vision go blurry or dark and having a headache.

A collateral history from someone that witnessed the event is essential to get an accurate

impression of what happened. During a vasovagal episode, they may describe that the person

suddenly lost consciousness and fell to the ground. They were unconscious on the ground for a few

seconds to a minute

as the blood returned to their brain. And there may be some twitching, shaking or convulsion activity

which can be confused with a seizure. The patient may feel a bit groggy after they've had a faint. However,

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