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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

[Edit Diagnosis] [Merge dx] [Add prevalence]

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
More, Edit...

The sensitivity and specificity of findings for Neurocardiogenic Syncope are listed below. See the left navigation bar to change the display.

Combination of Tests

Finding SensitivitySpecificity Comments, Study
Clinical diagnosis Edit 76%88%

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Fluid Test

Finding SensitivitySpecificity Comments, Study
Xanthochromia Edit 71%95%

(in CSF)

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

History

Finding SensitivitySpecificity Comments, Study
Headache Edit 46%82%

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Physical Exam

Finding SensitivitySpecificity Comments, Study
Carotid Bruit Edit 1%93%

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Hypertension Edit 48%89%

diastolic > 110mmHg

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Neck Stiffness Edit 20%97%

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Untagged

Finding SensitivitySpecificity Comments, Study
Acute Onset Edit 44%32%

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Alert Edit 23%31%

i.e. as opposed to drowsy or comatose

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Atrial Fibrillation Edit 2%82%

on EKG

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Coma Edit 35%94%

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Kernig or Brudzinski Sign Edit 15%98%

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Prior TIA Edit 7%79%

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Seizure Edit 9%98%

Differential Diagnosis: Stroke

Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Tilt Table Test Edit 75%55%

resulting in syncope after isoproterenol administration

Differential Diagnosis: Syncope

Study: Ann Intern Med 1992 Mar 1;116(5):358-63. PMID 1736767