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Recurrent syncope from parapharyngeal cancer
  1. Mark Howard
  1. Palliative Care, Saint Francis Hospice, Romford, UK
  1. Correspondence to Dr Mark Howard, Palliative Care, Saint Francis Hospice, Romford RM41QH, UK; markhoward{at}


The glossopharyngeal nerve is a cause of reflex bradycardia and syncope in patients with head and neck cancer. These clinical syndromes are rare but can be debilitating with variation in clinical presentation. The underlying mechanism is often incorrectly assumed to be carotid sinus hypersensitivity due to the cancerous lesion; however, examples in the literature also report the effect on the glossopharyngeal nerve or its branches by parapharyngeal lesions. We report two such cases known to a palliative care service. The symptomatic treatment options were limited due to patients’ frailty. Both patients experienced some reduction in their syncopal symptoms with anticholinergic agents.

  • head and neck
  • hospice care
  • symptoms and symptom management
  • hospital care

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  • Contributors MH is responsible for write up.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.