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Syncope in childhood

M L McHarg1, S Shinnar, H Rascoff

  • 1Department of Neurology, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467, USA.

Pediatric Cardiology
|September 1, 1997
PubMed
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Evaluating pediatric syncope is crucial, as a quarter of cases reveal serious, treatable conditions like migraines, seizures, or cardiac arrhythmias, not just vasovagal syncope.

Area of Science:

  • Pediatric Neurology
  • Pediatric Cardiology
  • Clinical Medicine

Background:

  • Syncope in children presents a diagnostic challenge.
  • Distinguishing vasovagal syncope from other causes is difficult.
  • Referrals for syncope evaluation are common in pediatric clinics.

Purpose of the Study:

  • To determine the incidence of various etiologies in pediatric syncope.
  • To identify clinical features that differentiate syncope causes in children.
  • To emphasize the importance of actively seeking serious disorders in pediatric syncope.

Main Methods:

  • Retrospective and prospective review of 108 pediatric patients (ages 2-19) evaluated for syncope.
  • Defined syncope as transient loss of consciousness with undetermined etiology at presentation.

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  • Correlated medical history, family history, clinical features, and diagnostic tests with final diagnoses over a mean 2.0-year follow-up.

    • Main Results:

    • An etiology for syncope was identified in 27% of cases.
    • Identified etiologies included migraines (11%), seizures (8%), and cardiac arrhythmias (6%).
    • No specific clinical or historical features reliably distinguished vasovagal syncope from other causes.

    Conclusions:

    • Pediatric syncope evaluations frequently uncover serious, treatable conditions beyond vasovagal syncope.
    • Active investigation for underlying disorders like migraines, seizures, and cardiac issues is essential.
    • Clinical and historical data alone are insufficient to reliably differentiate pediatric syncope etiologies.