Etiology of syncope in children: how often should we consider it neurogenic?

Sažetak

The most common paroxysmal non-epileptic events in children are syncopes, a sudden and temporary loss of consciousness provoked by stimuli, followed by the loss of postural tone and with complete recovery within seconds to minutes. The aim of this study was to determine the causes, provocations, diagnostic procedures and classification of syncopes in children and adolescents. Data on patients admitted because of syncope to our Neuropediatric Unit during a 2-year period (January 2005 to December 2006) were retrospectively analyzed. Out of 326 children with non-paroxysmal events, 68 children diagnosed with syncope were chosen for further analysis. The mean age of study children (female 70% and male 30%) was 13.67 years. About 70% of children were admitted urgently. Two or more syncopal attacks were recorded in 49% of children. Laboratory, neurologic and cardiologic procedures were performed, depending on history and physical examination. The causes of syncopal attacks were vasovagal, situational, orthostatic hypotension, spasm of the right vertebral artery, psychogenic, canal for vertebral artery, and epilepsy. In 5.9% of cases, syncopal attacks remained unclassified. The most common syncope in hospitalized children was neurocardiogenic. The diagnosis was mostly based on disease history and physical examination. EEG and follow up confirmed epilepsy in two children.