Recurrent syncope due to systemic mastocytosis.

A 59-year-old white woman, B. L., had been plagued by recurrent episodes of flushing, weakness, and dizziness that at times led to frank syncope. She had been well until December, 1974, when she experienced her first attack. This episode was characterized by the sudden onset of headache and fatigue followed by severe flushing (particularly of the face and neck), weakness of the legs, a feeling of malaise, and shortly thereafter, severe dizziness. Nevertheless, she recovered spontaneously after resting in the supine position for about 30 minutes. After the attack, she continued to experience profound fatigue and weakness for approximately 60 minutes during which time she defecated and urinated abruptly. However, she was not incontinent during or after the attack, and no seizure activity was noted with this or subsequent episodes. From 1974 until the end of 1982 she experienced six severe attacks, all associated with marked dizziness