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Korean Journal of Pediatrics 2008;51(5):512-517.
Published online May 15, 2008.
The characteristics of neurocardiogenic syncope in children
Kyung Yeon Lee1, Jin Young Lee1, Myoung Hyun Kim1, Jeong Eun Lee1, Yong Dae Kim2, Eun Ju Lee3, Young Su Lim3, Won Seop 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
소아 신경-심인성 실신의 특징
이경연1, 이진명1, 김명현1, 이정은1, 김용대2, 이은주3, 임명수3, 김원섭3
1청주성모병원 소아청소년과
2충북대학교 의과대학 예방의학교실
3충북대학교 의과대학 소아과학교실
Correspondence:  Won Seop 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.
Key Words: Syncope, Child


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