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Neurocardiogenic Syncope: Sensitivity and Specificity

Introduction:

Versus Ischemic Stroke. See also Subarachnoid Hemorrhage which shares some of the same findings (i.e. when intraparenchymal blood crosses into the subarachnoid space).

Great review of many findings (not all listed here): JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

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Tags: Cardiac Problem Neurologic Tag this Diagnosis.

Differential Diagnoses include: Stroke, Syncope

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Patients with syncope 33% J Am Coll Cardiol 2001 Jun 1;37(7):1921-8. PMID 11401133
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The sensitivity and specificity of findings for Neurocardiogenic Syncope are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %. Post-Test Probability (Predictive Value): %. Switch to display mode.
**Note that calculating probabilities from more than one finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)
Specific Findings
FindingResult SensitivitySpecificity
[ + ] Kernig or Brudzinski Sign + 0 - 15%98%
[ + ] Seizure + 0 - 9%98%
[ + ] Neck Stiffness + 0 - 20%97%
[ + ] Xanthochromia + 0 - 71%95%
[ + ] Coma + 0 - 35%94%
[ + ] Carotid Bruit + 0 - 1%93%
[ + ] Hypertension + 0 - 48%89%
[ + ] Clinical diagnosis + 0 - 76%88%
Negative Findings
FindingResult SensitivitySpecificity
[ + ] Carotid Bruit + 0 - 1%93%
[ + ] Atrial Fibrillation + 0 - 2%82%
[ + ] Prior TIA + 0 - 7%79%
[ + ] Acute Onset + 0 - 44%32%
[ + ] Alert + 0 - 23%31%
Poorly Diagnostic Findings
FindingResult SensitivitySpecificity
[ + ] Headache + 0 - 46%82%
[ + ] Tilt Table Test + 0 - 75%55%