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Syncope associated with pain as the presenting feature of neck malignancy: failure of cardiac pacemaker to prevent attacks in two cases

The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1, UK

Correspondence to:
Correspondence to:
Dr Paul Worth
Consultant Neurologist, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK; paul.worth{at}nnuh.nhs.uk

ABSTRACT
Two patients are described in whom syncope was the presenting clinical feature of an undiagnosed neck malignancy. Both patients also had attacks associated with paroxysms of severe neck pain. Neither patient responded to cardiac pacing.

Abbreviations: CSM, carotid sinus massage; CSS, carotid sinus syndrome

Keywords: asystole; carotid sinus syncope; glossopharyngeal neuralgia; neck malignancy