A Bone-Breaking Case of Syncope Due to Glossopharyngeal Neuralgia
Bibliographic record
Abstract
Glossopharyngeal neuralgia is an uncommon cause of intense facial pain, and is rarely associated with syncope. We present a patient with malignant syncope precipitated by glossopharyngeal neuralgia (GPN), who sustained lower extremity fractures. A 64-year-old Caucasian female with hypertension, diabetes mellitus type 2 and dyslipidemia, presented to the emergency department (ED) after a witnessed syncopal event. Over the preceding 9 months, she experienced multiple syncopal episodes triggered by neck pain, and was diagnosed with GPN by an ENT specialist. She reported a severe, stabbing pain in the right side of her neck prior to the event. Her vital signs and physical examination were unremarkable, except for bilateral leg tenderness. Laboratory data were within normal limits. Electrocardiogram revealed normal sinus rhythm, a rate of 72 beats per minute (BPM), and otherwise normal. Lower extremity X-rays revealed bilateral non-displaced fibular fractures. In the ED, she sustained another syncopal event, and bradycardia with transient heart rates as low as 22 BPM were documented. A temporary transvenous pacemaker was placed. She required pacing repeatedly for repeated bradycardic episodes preceded by right-sided neck pain. She was started on carbamazepine, without complete resolution of her symptoms on escalating doses. Due to recurrent bradycardia with frequent neck pains, requiring temporary pacing, an MRI-compatible permanent pacemaker was placed, to allow for further MRI recommended by neurology service. At 8-week follow-up, she had fully recovered from her neuralgic pain and fractures, without further syncope. This case emphasizes the potentially serious morbidity of GPN-induced syncope and importance of a prompt clinical diagnosis and treatment. J Med Cases. 2014;5(8):459-462 doi: http://dx.doi.org/10.14740/jmc1875w
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".