Syncope due to a neurogenic cause is relatively uncommon.


Causes of neurogenic syncope:

(1) basilar artery insufficiency or occlusion, with brain stem ischemia

(2) compression of a vertebral artery (cervical rib, cervical osteoarthritis, cervical spondylosis)

(3) subclavian steal syndrome (syncope occurs during arm exercising)

(4) basilar migraine


Features of brain stem ischemia may include:

(1) transient loss of consciousness

(2) diplopia

(3) vertigo

(4) ataxia

(5) dysarthria

(6) paresthesias

(7) muscle weakness


Exclusion: seizure disorder, other forms of syncope


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