All issues > Volume 51(5); 2008

Original Article

Korean J Pediatr. 2008;51(5):512-517. Published online May 15, 2008.

The characteristics of neurocardiogenic syncope in children

Kyung Yeon KY Lee¹, Jin Young JY Lee¹, Myoung Hyun MH Kim¹, Jeong Eun JE Lee¹, Yong Dae YD Kim², Eun Ju EJ Lee³, Young Su YS Lim³, Won Seop WS Kim³

¹Department of Pediatrics, Cheongju St. Mary's Hospital, Cheongju, Korea
²Department of Preventive Medicine, Chungbuk National University, Cheongju, Korea
³Department of Pediatrics, Chungbuk National University, Cheongju, Korea

Correspondence Won Seop WS Kim ,Email: eyunkim@yahoo.co.kr

Abstract

Purpose
: Syncope is relatively common in children and adolescents. Among the etiologies of syncope, neurocardiogenical syncope is the most common, but it is often confounded with seizure. We investigated the clinical features of patients under the age of 15 with neurocardiogenical syncope, compared to patients with neurologic disorders including epilepsy.
Methods
: Among the children who visited the Department of Pediatrics at Cheongju St. Mary's Hospital and Chungbuk National University Hospital from March 2005 to February 2007, we retrospectively analyzed 69 patients whose chief complaint was syncope. We classified the patients by syncope etiology and made comparisons between the neurocardiogenical syncope (NCS) group and the neurological disorders (ND) group regarding to age; location; time and season in which syncope occurred; associated symptoms, including seizures, provocation factors; prodromes; duration of syncope; frequency of previous syncope; birth history; associated disease; past medical history; family history; neurological exam; physical exam; laboratory findings; electrocardiography; electroencephalography (EEG); head-up tilt test; brain CT; and MRI.
Results
: Among 69 syncope patients, 53 (76.8%) were in the NCS group and 11 (15.9%) were in the ND group. There were no statistically significant differences between the two study groups except for the presence of prodromes and EEG abnormalities. The presence of prodromes in the NCS group was more common than in the ND group [46.9% (23/49) vs. 9.1% (1/11), (P=0.038)]. The EEG abnormality in the ND group was more common than in the NCS group [90% (9/10) vs. 5.8% (3/52), (P<0.01)].
Conclusion
: Our study suggests that detailed history-taking, including that concerning prodromes, is important for the accurate diagnosis of neurocardiogenical syncope, and EEG should be obtained if neurological disorders are suggested.

Keywords :Syncope, Child