Res Vestib Sci.  2018 Jun;17(2):67-70. 10.21790/rvs.2018.17.2.67.

Postprandial Dizziness/Syncope Relieved by Alfa-Glucosidase Inhibitor: A Case Report

Affiliations
  • 1Department of Neurology, Chungnam National University School of Medicine, Daejeon, Korea. mseaj@hanmail.net
  • 2Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.

Abstract

A 74-year-old man presented with positional vertigo and prandial dizziness and syncope. He had experienced episodes of frequent dizziness and loss of consciousness for several months. He underwent total gastrectomy with esophagojejunostomy and brown anastomosis 30 years ago. Thirteen years ago, subtotal colectomy with ileo-descending colostomy was done due to colon cancer. And he also had mitral valve replacement and maze operation due to severe mitral valve stenosis and atrial fibrillation. After cardiac operation, he has suffered from sudden dizziness with diaphoresis and chalky face, which usually occurs especially within 30 minutes from the onset of eating. Sometimes, this event was followed by several seconds of loss of consciousness, which caused recurrent events of falling. Neurological examination showed positional nystagmus compatible with benign paroxysmal positional vertigo arising from posterior semicircular canal of the right ear. The positional vertigo disappeared immediately after canalith repositioning maneuver. We tried to monitor vital signs and serum level of glucose during eating. Hyperglycemia (range, 210-466 mg/dL) was noted during eating, which was accompanied by postprandial and prandial hypotension, up to 60/40 mmHg. The patient was prescribed 100 mg of the alfa-glucosidase, acarbose to be taken half an hour before each meal. Eventually, the treatment with acarbose ameliorated the prandial dizziness and hypotension associated with hyperglycemia. Our patient suggests the acarbose could prevent postprandial dizziness and hypotension.

Keyword

Postprandial dizziness; Syncope; Alfa-glucosidase inhibitor

MeSH Terms

Acarbose
Accidental Falls
Aged
Atrial Fibrillation
Benign Paroxysmal Positional Vertigo
Colectomy
Colonic Neoplasms
Colostomy
Dizziness
Ear
Eating
Gastrectomy
Glucose
Humans
Hyperglycemia
Hypotension
Meals
Mitral Valve
Mitral Valve Stenosis
Neurologic Examination
Nystagmus, Physiologic
Semicircular Canals
Syncope
Unconsciousness
Vertigo
Vital Signs
Acarbose
Glucose
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