All issues > Volume 46(12); 2003

Case Report

J Korean Pediatr Soc. 2003;46(12):1274-1278. Published online December 15, 2003.

A Case of Micturition Syncope in a Child

Sun Youn SY Lee¹, Su Jeong SJ Ryu¹, Deok Soo DS Kim², Young Hwue YH Kim¹, Tae Sung TS Ko¹, Jae Moon JM Kim³

¹Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
²Department of Pediatrics, Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University, Seoul, Korea
³Department of Neurology, College of Medicine, Chungnam National University, Taejon, Korea

Correspondence Tae Sung TS Ko ,Email: tsko@amc.seoul.kr

Abstract

Syncope in children and adolescents have a common occurrence according for up to 15% before adulthood. Micturition syncope, a kind of situational syncope, can be considered a form of reflex syncope. It can typically occur in healthy young men after rising from bed in the early morning who experience sudden loss of consciousness during or immediately after urination. The mechanism of micturition syncope is not completely understood, but it has been suggested that vasovagal reflex mediated bradycardia and peripheral vasodilation and decreased venous return due to Valsalva effect and standing position lead to the decrease in cerebral blood flow resulting in syncope. The causes of syncope are variable. So complete history taking, physical examination, electrocardiography, exercise stress test, echocardiography, head-up tilt table test, electroencephalography(EEG), brain magnetic resonance image and urodynamic study should be required for the diagnosis of micturition syncope. There were several reports about micturition syncope. However, literature of micturition syncope at the pediatric age has rarely been reported in Korea so far. Therefore, we report a case of a 9- year-old boy with micturition syncope with typical EEG findings of high amplitude delta wave and flattening during syncope.

Keywords :Syncope, Micturition, Head-up tilt test, Electroencephalography