Patient discussions

Patients should contact their physician if there is a change in frequency or presentation of symptoms.

Patient education is an important factor in treatment for all types of NMRS.[1] Patients should avoid or mitigate situations where syncope has occurred in the past (e.g., prolonged standing, pain, emotional distress, defecation, dehydration).[1] If they experience prodromal symptoms (e.g., dizziness, changes in vision/hearing), advise patients to lie down if possible (and if it is safe to do so) with their legs elevated. Patients may try arm counter-pulsation (pulling contralateral hands against each other, hooking the hands together, and pulling with the arms), leg tensing, and leg crossing to try to improve venous return to the heart, and therefore perfusion of the brain.[56][57] For prevention, patients can try support stockings that extend to the thigh. 

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