swoon is a common problem in childr...

swoon is a common problem in children presenting to necessity departments. Before adolescence, about 15 percent of children have at least single in kind episode of sudden transient los of consciousness with spontaneous retrieval The cause usually is benign yet may reflect significant cardiac, neurologic, or metabolic pathology.

Massin and associates evaluated the medical records of a series of children presenting to an urgency department with syncope beginning in 1998 Participants were followed passively by the and of their medical records until the summer of 2003 to identify further information that may have been related to the initial syncopal episode.

Among the 226 patients who had 252 presentations to the strait department for syncope, 144 were discharged directly, and 82 were admitted to the hospital. Neurocardiogenic fainting was the most common diagnosis (181 patients), with neurologic vexed questions (most frequently, convulsive disorder) being identified in 21 patients. Cardiac vexed questions were identified in five patients; in the remaining patients, psychogenic point to be solved [i]or[/i] settleds breath-holding spells, or intoxication by the agency of poisoning or drug overdose was determined to be the cause of swoon with isolated cases of obstructive respiratory disease, hypoglycemia, and aplastic crisis. return was associated with psychogenic and cardiac causes. Physical examinations were normal in 218 children, although cardiovascular and neurologic findings were useful in a small assign places to of patients.

The authors infer that a careful history focusing in succession events leading up to the syncopal episode and a perfect physical examination seem to direct the choice of appropriate diagnostic testing (see accompanying figure). If the initial work-up does not reveal the diagnosis, bring to a period follow-up may clarify it. Psychiatric disorders should be considered in children with neurocardiogenic syncope

Massin MM et al. fainting in pediatric patients presenting to an turn of events department. J Pediatr August 2004;145:223-8

COPYRIGHT 2005 American Academy of Family Physicians

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