RT Journal Article SR Electronic T1 Recurrent syncope from parapharyngeal cancer JF BMJ Supportive & Palliative Care JO BMJ Support Palliat Care FD British Medical Journal Publishing Group SP bmjspcare-2021-003225 DO 10.1136/bmjspcare-2021-003225 A1 Mark Howard YR 2021 UL http://spcare.bmj.com/content/early/2021/07/14/bmjspcare-2021-003225.abstract AB 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.