The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Tilt-induced vasovagal syncope and psychogenic pseudosyncope: Overlapping clinical entities
Open accessAbstract
OBJECTIVE: To describe the combination of tilt-induced vasovagal syncope (VVS) and psychogenic pseudosyncope (PPS) and aid its clinical recognition. METHODS: We identified people with tilt-induced VVS/PPS from 2 tertiary syncope referral centers. For each case, 3 controls with tilt-induced VVS were selected at random from the same center. Clinical characteristics were compared between both groups adjusting for multiple comparisons. RESULTS: Of 1,164 tilt-table tests, 23 (2%) resulted in VVS/PPS; these 23 cases were compared with 69 VVS controls. VVS and PPS coincided more often than chance would predict: 2% vs 0.6%, p < 0.001. Typical VVS prodromes and triggers were reported in all people with VVS/PPS and in controls with VVS. Attack frequency was significantly higher in the VVS/PPS (2 per month, range 0.1-60) than in the VVS group (0.25 per month, range 0.02-4; p < 0.001). Delayed recovery of consciousness was more frequently reported in the VVS/PPS group (likelihood ratio [+LR] 8.14, 95% confidence interval [CI] 3.94-16.84), as well as episodes without prodromes (+LR 5.57, 95% CI 2.53-12.26), atypical triggers (+LR 5.00, 95% CI 2.04-12.24), eye closure (+LR 3.75, 95% CI 1.68-8.35), and apparent loss of consciousness >1 minute (+LR 2.86, 95% CI 1.98-4.13). CONCLUSIONS: VVS/PPS presents with a complex phenotype. High attack frequency, delayed recovery of consciousness, apparent loss of consciousness >1 minute, ictal eye closure, atypical triggers, and the absence of prodromes may serve as indicators that PPS coincides with VVS.
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“Tilt testing may be helpful in separating syncope from PPS.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [117]
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“a normal EEG helps to confirm the diagnosis. 116,117”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [117]
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“The method has been proven to show the combined presence of VVS and PPS. 117”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [117]
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Rossi, P., Andriesse, G. I., Oey, P. L., Wieneke, G. H., Roelofs, J. M. M., & Akkermans, L. M. A. (1998) · Journal of the Neurological Sciences · doi:10.1016/s0022-510x(98)00276-7 · Cited by 767
Management of Vasovagal Syncope: Controlling or Aborting Faints by Leg Crossing and Muscle Tensing
Krediet, C. T. P., van Dijk, N., Linzer, M., van Lieshout, J. J., & Wieling, W. (2002) · Circulation · doi:10.1161/01.cir.0000030939.12646.8f · Cited by 372
Bodde, N. M. G., Brooks, J., Baker, G. A., Boon, P., Hendriksen, J. G. M., Mulder, O. G., & Aldenkamp, A. P. (2009) · Seizure · doi:10.1016/j.seizure.2009.06.006 · Cited by 315
Bartoletti, A. (2000) · Europace · doi:10.1053/eupc.2000.0125 · Cited by 315
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Symptoms and signs of syncope: a review of the link between physiology and clinical clues
Wieling, W., Thijs, R. D., van Dijk, N., Wilde, A. A. M., Benditt, D. G., & van Dijk, J. G. (2009) · Brain · doi:10.1093/brain/awp179 · Cited by 265
Self-citationThe semiology of tilt-induced reflex syncope in relation to electroencephalographic changes
van Dijk, J. G., Thijs, R. D., van Zwet, E., Tannemaat, M. R., van Niekerk, J., Benditt, D. G., & Wieling, W. (2014) · Brain · doi:10.1093/brain/awt332 · Cited by 160
Self-citationA guide to disorders causing transient loss of consciousness: focus on syncope
van Dijk, J. G., Thijs, R. D., Benditt, D. G., & Wieling, W. (2009) · Nature Reviews Neurology · doi:10.1038/nrneurol.2009.99 · Cited by 137
Self-citationPsychogenic pseudosyncope: An underestimated and provable diagnosis
Benbadis, S. R., & Chichkova, R. I. (2006) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2006.02.011 · Cited by 102
The semiology of tilt-induced psychogenic pseudosyncope
Tannemaat, M. R., van Niekerk, J., Reijntjes, R. H., Thijs, R. D., Sutton, R., & van Dijk, J. G. (2013) · Neurology · doi:10.1212/wnl.0b013e3182a1aa88 · Cited by 99
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2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951
Self-citationLong-term follow-up of psychogenic pseudosyncope
Saal, D. P., Overdijk, M. J., Thijs, R. D., van Vliet, I. M., & van Dijk, J. G. (2016) · Neurology · doi:10.1212/wnl.0000000000003361 · Cited by 25
Self-citationChildhood trauma and lifetime syncope burden among older adults
O'Hare, C., McCrory, C., O'Leary, N., O'Brien, H., & Kenny, R. A. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.03.019 · Cited by 18
Metadata
- Authors
- Blad, H., Lamberts, R. J., van Dijk, J. G., & Thijs, R. D.
- Affiliations
- Leiden University Medical Center (NL)
- From Stichting Epilepsie Instellingen Nederland (SEIN) (H.B., R.J.L., R.D.T.), Heemstede; and the Department of Neurology (J.G.v.D., R.D.T.), Leiden University Medical Centre, the Netherlands.
- ORCID
- Thijs, Roland D.
- Venue
- Neurology
- Published
- 2015-12-08
- Volume
- 85
- Issue
- 23
- Pages
- 2006-2010
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC4676758
- OpenAlex
- W2209202140
- Cited by
- 57
- References
- 23
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 7 · 2019: 7 · 2018: 8 · 2017: 9 · 2016: 8 · 2015: 1
- FWCI
- 8.73
- Type
- journal article
- Language
- en
- Update notices
- correction (2017-01-16)
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Funders
- UCB Pharma
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Keywords
- vasovagal syncope, tilt table test, attack frequency, prodromal symptoms, eyelid closure
- MeSH terms
- Adolescent, Adult, Aged, Child, Female, Humans, Male, Middle Aged, Retrospective Studies, Syncope, Tilt-Table Test, Syncope, Vasovagal, Young Adult
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