People often stretch to loosen up their contracted bodies after waking up or sitting for a long time. When stretching by bending the neck and back backward, some may experience darkening vision or even lose consciousness, and this should not be dismissed as simple dizziness. It could be stretch syncope, a situational fainting episode that occurs after extending the neck, back, or shoulders.
◇‘Stretch syncope’ causes loss of consciousness after stretching
Stretch syncope is a rare form of fainting in which symptoms recur in a specific position. According to a study published in the journal ‘Trends in Cardiovascular Medicine,’ researchers identified 30 patients aged 5 to 26 who experienced stretch syncope. They briefly lost consciousness after bending their necks backward or extending their upper backs. Rather than focusing only on brief dizziness after stretching once, it is important to determine whether darkening vision or loss of consciousness repeatedly occurs when the same movement is performed.
In the past, the condition was thought to result from compression of the vertebral artery when the neck was bent backward, reducing blood flow to the brain. More recently, researchers have proposed that a neural reflex to the stimulus of extending the body causes blood pressure to drop excessively, while the heart fails to respond sufficiently by beating faster to raise blood pressure again. According to a study published in the journal ‘Heart Rhythm,’ researchers measured blood pressure and heart rate in nine patients with stretch syncope and 24 healthy controls while their shoulders and upper backs were extended for 10 to 15 seconds. The patient group showed a tendency toward greater declines in systolic blood pressure and mean arterial pressure than the control group.
◇Arms and face may twitch during a fall
When stretch syncope lasts for an extended period, repeated twitching of the face or arms may occur, sometimes leading it to be mistaken for an epileptic seizure. According to a study published in the journal ‘Epilepsy&Behavior,’ researchers recorded 57 episodes of stretch syncope in three patients using video and electroencephalography. In episodes involving impaired consciousness, generalized slowing appeared on electroencephalograms 9 to 16 seconds after stretching. This indicates that brain activity had slowed compared with normal and can occur when consciousness is impaired. At the same time, blood flow in the middle cerebral artery also decreased sharply, and when this situation persisted for a prolonged period, repeated twitching of the face and arms was observed.
◇How is stretch syncope diagnosed?
If the same symptoms repeatedly occur when stretching, it is advisable to remember when they occur, in what position, and how many seconds afterward, and report this information during a medical consultation. Medical professionals check the patient’s medical history, electrocardiogram, blood pressure and autonomic nervous system tests, and, if necessary, electroencephalography to determine whether other conditions that can cause fainting, such as arrhythmia or epilepsy, are present. For diagnosis, video-electroencephalography and beat-to-beat blood pressure, measured continuously with each heartbeat, may also be performed while the patient carries out the symptom-triggering movement under medical supervision. However, people should not repeatedly stretch alone while excessively bending their necks backward or holding their breath in an attempt to confirm the symptoms. No medication has been proven to be definitively effective for stretch syncope, and avoiding positions that trigger symptoms is the basic approach.
◇‘Stretch syncope’ causes loss of consciousness after stretching
Stretch syncope is a rare form of fainting in which symptoms recur in a specific position. According to a study published in the journal ‘Trends in Cardiovascular Medicine,’ researchers identified 30 patients aged 5 to 26 who experienced stretch syncope. They briefly lost consciousness after bending their necks backward or extending their upper backs. Rather than focusing only on brief dizziness after stretching once, it is important to determine whether darkening vision or loss of consciousness repeatedly occurs when the same movement is performed.
In the past, the condition was thought to result from compression of the vertebral artery when the neck was bent backward, reducing blood flow to the brain. More recently, researchers have proposed that a neural reflex to the stimulus of extending the body causes blood pressure to drop excessively, while the heart fails to respond sufficiently by beating faster to raise blood pressure again. According to a study published in the journal ‘Heart Rhythm,’ researchers measured blood pressure and heart rate in nine patients with stretch syncope and 24 healthy controls while their shoulders and upper backs were extended for 10 to 15 seconds. The patient group showed a tendency toward greater declines in systolic blood pressure and mean arterial pressure than the control group.
◇Arms and face may twitch during a fall
When stretch syncope lasts for an extended period, repeated twitching of the face or arms may occur, sometimes leading it to be mistaken for an epileptic seizure. According to a study published in the journal ‘Epilepsy&Behavior,’ researchers recorded 57 episodes of stretch syncope in three patients using video and electroencephalography. In episodes involving impaired consciousness, generalized slowing appeared on electroencephalograms 9 to 16 seconds after stretching. This indicates that brain activity had slowed compared with normal and can occur when consciousness is impaired. At the same time, blood flow in the middle cerebral artery also decreased sharply, and when this situation persisted for a prolonged period, repeated twitching of the face and arms was observed.
◇How is stretch syncope diagnosed?
If the same symptoms repeatedly occur when stretching, it is advisable to remember when they occur, in what position, and how many seconds afterward, and report this information during a medical consultation. Medical professionals check the patient’s medical history, electrocardiogram, blood pressure and autonomic nervous system tests, and, if necessary, electroencephalography to determine whether other conditions that can cause fainting, such as arrhythmia or epilepsy, are present. For diagnosis, video-electroencephalography and beat-to-beat blood pressure, measured continuously with each heartbeat, may also be performed while the patient carries out the symptom-triggering movement under medical supervision. However, people should not repeatedly stretch alone while excessively bending their necks backward or holding their breath in an attempt to confirm the symptoms. No medication has been proven to be definitively effective for stretch syncope, and avoiding positions that trigger symptoms is the basic approach.