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ABSTRACT
Micturition syncope: report of two cases
Syncope is a symptom which is a transient loss of consciousness and very common in society and is one of the most important referral causes to emergency services. Micturition syncope (MS) appears as a rare cause of neurally-mediated syncope. MS is caused by reflex which results with vasodilatation and bradycardia, like defecation syncope. In the clinical setting, the MS is presented with transient loss of consciousness during supine position or micturition following after a sleep period mostly in otherwise healthy men. It is a reflex state in which standing triggers vasodilatation and bradicardia. MS covers 2-8% of all syncopes. There is still no consensus about treatment and outcome of MS. In this article two male patients with MS are presented. With these two cases, we aimed to give detailed information about micturition syncope which is a rare type of syncope.
Key words: Syncope, micturition syncope, vasovagal reflex
ÖZET
Miksiyon senkobu: iki olgu sunumu
Toplumda sik görülen ve acil servise ba^vurunun önemli nedenlerinden oían senkop, kisa süreli geçici bilinç kaybi i le karakterizedir. Miksiyon senkobu (MS), nöral kökenli refleks send rom la rindan birisidir. MS ve defekasyon senkobu, vazodilatasyon ve bradikardi ile sonuçlanan refleks nedeniyle ortaya çikmaktadir. Klasik olarak MS saglikli insanlarda, uykudan uyanip idrar yapma sonrasi geliçen senkop çeklinde tarif edilmektedir. Halen MS hakkindaki bilgiler çok sinirlidir. MS tüm senkoplarin %2-8'ini oluçturmaktadir. MS'nin tedavi ve sonuçlari konusunda halen görü§ birligi yoktur. Sunacagimiz iki olgu ile nadir görülen bir senkop çeçidi oían miksiyon senkobu na ait ayrintili bir degerlendirme yapilmasi amaçlanmiçtir.
Anahtar kelimeler: Senkop, miksiyon senkobu, vazovagal refleks
INTRODUCTION
The micturition syncope was first reported by Rugg-Gunn (1) in 1946 as a syncope occurring immediately after urination. However no study had been conducted on this syndrome during the following ten years. A study of 40 cases including 3 women reported by Gestaut is the most comprehensive study on this syndrome (2). The number of the studies gradually increased during the ensuing period, even familial forms were reported.
As with all types of syncope, differential diagnosis of MS from epilepsy and the other causes of syncope should also be considered. This is an important clinical situation that may guide the treatment. According to the hypothesis of Chakravarty (3),...