Etiology and Neuruological Evaluation of Non-Cardiogenic Syncope in Children

Authors : Ülkühan ÖZTOPRAK

Pages : 111-115

View : 25 | Download : 8

Publication Date : 2019-12-10

Article Type : Conference Paper

Abstract :Aim: The aim of this study was to evaluate the clinical characteristics, etiology, and the value of neurologic investigations in the diagnosis of syncope in children. Material and Method : The records of 218 patients insert ignore into journalissuearticles values(124 female, 94 male; mean age: 12.8 ± 4.1); admitted to our pediatric neurology outpatient clinic between January 2016 and December 2018 were retrospectively reviewed for age, sex, number of syncopal events, history of syncope, results of neurological diagnostic tests. Patients with known epilepsy, no eyewitness during syncope, and patients with structural heart disease or arrhythmia on cardiologic examination were excluded. Results: Eighty six insert ignore into journalissuearticles values(39.4%); patients had one syncopal event, 80 insert ignore into journalissuearticles values(36.7%); patients had two, 31 insert ignore into journalissuearticles values(14.2%); patients had three and 21 insert ignore into journalissuearticles values(9.6%); patients had more than three syncopal attacks. Prodromal findings before syncope were present in 80 % of patients, urinary incontinence during syncope were present in 6%, motor findings were present in 18.3%, postsyncopal findings were present in 14.2%. Twenty-one insert ignore into journalissuearticles values(9.6%); patients had a family history of epilepsy. Electroencephalography insert ignore into journalissuearticles values(EEG); was performed in all patients and revealed epileptic discharges in 19 insert ignore into journalissuearticles values(8.7%); of them. Neuroimaging studies were performed in 97 insert ignore into journalissuearticles values(44.4%); patients and revealed incidental white-matter lesions in 10insert ignore into journalissuearticles values(10.3%);, mega sisterna magna in 6insert ignore into journalissuearticles values(6.1%);, asymmetry of the lateral ventricles in 5insert ignore into journalissuearticles values(5.1%);, temporal lobe arachnoid cyst in 2insert ignore into journalissuearticles values(2%);, hydrocephalus in 1 insert ignore into journalissuearticles values(1%);, dysgenesis of corpus callosum in 1 insert ignore into journalissuearticles values(1%);, eosinophilic granuloma in 1 insert ignore into journalissuearticles values(1%); and leukodystrophy in 1 insert ignore into journalissuearticles values(1%);. The etiology was neurally mediated syncope in 181 patients insert ignore into journalissuearticles values(83%);, convulsive/epileptic syncope in 19 patients insert ignore into journalissuearticles values(8.7%);, psychogenic pseudosyncope in 16 patients insert ignore into journalissuearticles values(7.3%);, metabolic in 1 patient insert ignore into journalissuearticles values(1%);, drug induced syncope in 1 patient insert ignore into journalissuearticles values(1%);. Neurally- mediated syncope insert ignore into journalissuearticles values(NMS); was further grouped as vasovagal insert ignore into journalissuearticles values(n=172);, reflex-anoxic insert ignore into journalissuearticles values(breath holding); insert ignore into journalissuearticles values(n=6);, situationalinsert ignore into journalissuearticles values(post micturition syncope , n=6);. It was seen that 79.7% of vasovagal syncopes were caused by postural orthostatic condition and 20.3% were caused by pain stimulation. Conclusion: The history and comprehensive physical examination in children are in fact largely sufficient in the differential diagnosis of non-cardiogenic syncope. Although the contribution of neuroimaging to the etiology and diagnosis is very limited, electroencephalography may be helpful in diagnosis and treatment management in selected cases.
Keywords : Child, Non Cardiogenic Syncope, Anahtar kelimeler Çocuk