Etiology of Syncope in Children and the Value of Neurologic and Cardiologic Investigations in Diagnosis

Objective: Although neurocardiogenic syncope is the most common type of syncope in children, a wide variety of neurologic and cardiologic disorders may present with syncope. However, the diagnostic yield for most tests commonly used in the evaluation of children with syncope is low. We aimed to document the clinical characteristics, etiology, and the value of neurologic and cardiologic investigations in the diagnosis of syncope in children. Material and Methods: Hospital charts of 241 children (169 female and 72 male) who were referred to the pediatric neurology department due to syncope between July 2011 and December 2013 were retrospectively reviewed. Outcome variables were etiology and yield of diagnostic tests performed. Results: The etiology was neurocardiogenic syncope in 146 (60.6%), postural ortostatic tachycardia syndrome (POTS) in 30 (12.4%), epilepsy in 22 (9.1%), cardiac causes in 6 (2.5%), psychogenic pseudosyncope in 23 (9.5%), reflex syncope in 4 (1.7%), unspecified syncope in 9 (3.7%) patients and hydrocephalus in 1 (0.4%) patient. Electroencephalography was performed in 157 (65.1%) patients and revealed epileptic discharges in 25 (15.8%) of them. Neuroimaging studies 1