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Clinical categorization of childhood syncope
Francis J DiMario1, Cristina S Wheeler Castillo
1University of Connecticut School of Medicine, Farmington, CT, USA. fdimari@ccmckids.org
Journal of Child Neurology
|March 31, 2011
Summary
Syncope, a temporary loss of consciousness due to reduced blood flow to the brain, is often diagnosed effectively through detailed medical history. Laboratory tests are rarely diagnostic for syncope or concurrent epilepsy in children.
Area of Science:
- Pediatric Neurology
- Cardiology
Background:
- Syncope is a common cause of presentation in pediatric emergency departments.
- Understanding the etiology of syncope and its overlap with epilepsy is crucial for accurate diagnosis and management.
Purpose of the Study:
- To categorize the causes of syncope in pediatric patients.
- To determine the frequency of concurrent epilepsy in children presenting with syncope.
- To evaluate the diagnostic utility of various laboratory tests.
Main Methods:
- Retrospective chart review of 141 pediatric patients.
- Descriptive statistical analysis of collected data.
- Review of diagnostic test results including EEG, MRI/CT, ECG, and blood tests.
Main Results:
- Neurocardiogenic syncope was the primary diagnosis in 78% of subjects.
- Syncopal convulsions occurred in 38% of patients.
- Epilepsy was diagnosed concurrently in 2.8% of cases.
- Electroencephalograms and other laboratory tests were largely nondiagnostic, with medical history being the most effective diagnostic tool.
Conclusions:
- Neurocardiogenic syncope is the most frequent diagnosis in pediatric syncope referrals.
- Concurrent epilepsy is uncommon.
- Diagnostic laboratory testing has limited utility; a thorough medical history is paramount for diagnosing syncope in children.
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