Misjudged Bannwarth's syndrome culminating in laminectomy

Syncope is a very common presentation to the primary care provider and the emergency room physician. The consequences of syncope while driving can be tragic. Likewise the consequences in the flight environment can be devastating. This case presents tussive syncope while driving in a 41-yr-old previously healthy male aviator. The diagnosis, management, and aeromedical disposition are presented.