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The slow-flat-slow sequence in malignant vasovagal syncope.

Guy Vaksmann1, Ivan Bouzguenda1, Marie-Dominique Lamblin2

  • 1Department of Pediatric Cardiology, Hôpital Privé de La Louvière, Lille, France.

Annals of Pediatric Cardiology
|March 8, 2021
PubMed
Summary

Malignant vasovagal syncope in an 8-year-old boy was recorded using electroencephalography and electrocardiography. The tracing showed a specific "slow-flat-slow" pattern linked to severe cerebral hypoperfusion.

Keywords:
Asystoleconvulsive syncopeelectroencephalogrammalignant vasovagal syncope

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Area of Science:

  • Neurology
  • Cardiology
  • Pediatrics

Background:

  • Vasovagal syncope is a common cause of transient loss of consciousness.
  • Malignant vasovagal syncope is a rare but severe form, potentially leading to prolonged asystole and cerebral hypoperfusion.
  • Electroencephalography (EEG) and electrocardiography (ECG) are non-invasive tools for assessing brain and cardiac function.

Purpose of the Study:

  • To present a case of malignant vasovagal syncope in a pediatric patient.
  • To illustrate the characteristic electroencephalographic and electrocardiographic findings during such an event.
  • To highlight the association between specific EEG/ECG patterns and severe cerebral hypoperfusion.

Main Methods:

  • Simultaneous electroencephalography (EEG) and electrocardiography (ECG) monitoring were performed.
  • An 8-year-old boy experienced a vasovagal syncope episode during the recording.
  • The obtained tracings were analyzed for characteristic patterns.

Main Results:

  • The EEG and ECG recordings captured a vasovagal syncope episode.
  • A highly specific "slow-flat-slow" sequence was observed in the EEG.
  • This pattern is indicative of severe cerebral hypoperfusion during syncope.

Conclusions:

  • The "slow-flat-slow" EEG pattern is a specific marker for severe cerebral hypoperfusion during vasovagal syncope.
  • Simultaneous EEG/ECG monitoring can be valuable in diagnosing and understanding severe syncopal events in children.
  • This case underscores the importance of recognizing malignant vasovagal syncope and its neurophysiological correlates.