ReviewBMC neurology2025
Neuromyelitis optica spectrum disorders with recurrent syncope due to area postrema syndrome: a case report and literature review.
Review in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Intractable hiccups as a brainstem red flag: demyelinating disorders with emphasis on neuromyelitis optica spectrum disorder and area postrema syndrome.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- Diagnostic Challenges and Clinical Management of Area Postrema Syndrome: A Case Report on Persistent Nausea and Vomiting.Clinical case reports · 2026Article
- Syncope in AQP4-IgG-positive neuromyelitis optica spectrum disorder: a case series and literature review.Frontiers in neuroscience · 2026Article
- Complement C5 inhibitors as add-on rescue treatment in severe AQP4-antibody neuromyelitis optica spectrum disorder attacks: a case series and literature review.Therapeutic advances in neurological disorders · 2026Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundArea postrema syndrome is one of the core clinical features of neuromyelitis optica spectrum disorders (NMOSD), characterized by intractable hiccups, nausea, and vomiting. Brain MRI often reveals lesions in the dorsal medulla oblongata. However, recurrent syncope has rarely been described in NMOSD. In a few reported cases, patients have been diagnosed with bradycardia or orthostatic hypotension due to medullary lesions, often requiring pacemaker implantation or cardioneuroablation. CASE PRESENTATION: We reported a case of a 70-year-old female who presented with intractable nausea for 3 weeks and recurrent syncope for 2 days, while no remarkable lesions were found on brain MRI. A 24-h electrocardiogram (ECG) confirmed sick sinus syndrome, revealing multiple sinus pauses longer than 8 s. Meanwhile, high titer anti-aquaporin-4 immunoglobulin G was detected in her serum, leading to a diagnosis of NMOSD. Following treatment with one course of an intravenous methylprednisolone pulse and four courses of eculizumab, her symptoms of nausea and syncope resolved completely, her ECG normalized to sinus rhythm, and pacemaker implantation was successfully averted.
conclusionsNMOSD should be considered a differential diagnosis in patients with recurrent syncope accompanied by intractable hiccups, nausea, and vomiting. Prompt immunotherapy may be sufficient for rhythm recovery, potentially eliminating the need for invasive procedures.
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