Studies of Syncope

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Abstract
Certain physiologic and psychologic data are presented which the authors believe demonstrate the distinction between hysterical conversion and vegetative neurotic mechanisms as it relates to the problem of fainting. When patients were studied during spontaneous or provoked fainting or syncope, it was found that they could be classified into 2 groups. In one group the loss of consciousness is preceded by rather striking clinical manifestations including pallor, sweating, sighing respiration, hypotension and sometimes bradycardia. In the 2d group, consciousness is lost without any demonstrable changes in circulation or respiration. The clinical characteristics of the 1st group are those of vasodepressor syncope; those of the 2d group, hysterical fainting. Case histories are given of a patient suffering from each of the 2 types of fainting spells. Electrocardio-graphic and electroencephalographic records were also obtained from these patients during an induced period of fainting. It was found that the electroencephalogram of the patient whose fainting is described as vasodepressor syncope was characterized by high voltage, slow waves during the patient''s unconsciousness. Bradycardia also developed. The patient recovered consciousness promptly upon being placed in the recumbent position. The electroencephalogram of the patient suffering from hysterical fainting showed no abnormality during the period of unconsciousness and there were no significant changes in the electrocardiogram. Consciousness was not regained upon attaining the recumbent position.

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