A Preliminary Study Of Common Causes Of Syncope And Clinical Features In Children With 68 Cases Data Analysis And Literature Review

Objective :To explore the common causes of syncope and clinical characteristics in children,provide reference for clinical diagnosis and differential diagnosis,and provide Suggestions for early intervention treatment..Methods:Collected clinical datas of 68 patients with syncope as the chief complaint in March 2015 to March 2016 in affiliated children’s hospital of chongqing medical university neurology clinic,by asking the history, physical examination, and electroencephalography(EEG) and cranial CT,electrocardiogram(ECG) echocardiography and cerebral blood flow diagram and head-up tilt test(HUTT),and so on auxiliary examination index,to retrospectively analyze the common causes and clinical features in summary.Results:68 cases of syncope children aged 2 to 16 years old, average age(9.42±3.43).1. According to gender groups:31 cases is male,female has37 cases.Male:female=0.84:1,in the male and female,AMS type in childrenwith syncope was most common(respectively are 13 cases, 19.1%,22 cases,32.4%),there was no significant difference between men and women(P>0.05);2. According to age groups:preschool( < 6 years of age) group is 13cases(19.1%), learning age(6 to 12 years old) group is 36 cases(52.9%),adolescence( ≥12 years old) or higher group is 19 cases(27.9%),and with a significant difference between age groups(P<0.05),the most common is school-age children,not only the largest number, and the common in AMS,often before the attack with aura(26 cases, 38.2%),And the seizure duration is relatively short(30 cases, 44.1%), compared with other two age groups were significant or very significant difference(P < 0.050.01).3.According to the presence of precursor before the onset of syncope group: precursor group is 41 cases(60.3%),without aura group is 27 cases(39.7%),comparison between the two groups have significant difference(P< 0.05).4. According to the duration of syncope attack group: group of short time(< 5 min) is 52 cases(76.5%), longer group(5 min) is 16 cases(23.5%), comparison between the two groups have significant difference(P< 0.05).5. According to the cause of grouping: autonomic nerve mediated group is 35 cases(51.5%), brain source syncope group is 21 cases(30.9%),cardiac syncope group is 6 patients(8.8%) and unknown causes group of 6 patients(8.8%).5.1 in the autonomic nerve mediated group is 35 cases,in children with vasovagal syncope(VVS) is 29 cases(82.9%),orthostatic tachycardia syndrome(POTS) is 5 cases(14.3%),orthostatic hypotension(OH) is only 1 case(2.9%). 5.2 in brain syncope group epilepsy is 8(38.1%) and migraine headache epilepsy seizures is 10 cases,the majority(47.6%).6. According to the treatment effect(or outcome) group:the better group has 39 cases(75%),the poorer groups is29 cases(25%),the comparison between the two groups have significant differences in the AMS(P < 0.05). In better effect group,school-age children age is 25 cases(64.1%),more familiar,there is a significant differences between age group.And better effects is the female group with27 cases(69.2%),gender differences are significant(P < 0.05).Conclusion:This study based on the clinical records,relevant laboratory tests and make the necessary intervention treatment in 68 cases of children with syncope, after analysis and study preliminarily found:1.Syncope occurred in school-age children(6 to 12 years old) are the most common, is the highest incidence disease, its etiology is given priority to autonomic nerve mediated syncope(AMS), and vasovagal syncope is most common in AMS;2.The female children of syncope is more common,often accompanied aura by heart palpitations, chest tightness or headache, dizziness and so on;Most syncope in children is short duration, rapid recovery, and intervention effect is good.3.Although syncope is one of the more common critical situation inchildhood in the emergency department, but most syncope patients prognosis is good, and do not need to give long-term drug intervention therapy.4.In the causes which are lead to syncope occurred, although by seizures or heart disease, severe arrhythmia and cardiac structural abnormalities,etc.) leading to syncope occurred is rare, but its harmfulness is high, the prognosis is poorer,and may even lead to life danger, therefore we should pay great attention to it in the clinical work.5.Head-up tilt test(HUTT) is the gold standard for diagnosis and differential diagnosis of AMS, but electroencephalogram(EEG), cerebral blood flow chart, electrocardiogram(ECG), echocardiography, CT/MRI and other auxiliary examination are also the important way to diagnosis and differential diagnosis syncope which with and without cerebral source or cardiac syncope.