Transient loss of consciousness and syncope in children and young people: what you need to know

Syncope is a transient loss of consciousness resulting from an insufficient supply of oxygen to the brain and characterised by rapid onset, short duration, and spontaneous complete recovery. Up to 15% of children will experience at least 1 episode before the age of 18 and a population based study suggested the causes were vasovagal (75%), cardiac disease (10%), psychogenic or unexplained (8%) and epilepsy (5%).

The key to diagnosis is in the history. A video of the event is invaluable, a 12-lead ECG mandatory, blood sugar and postural BP monitoring helpful. An EEG should not be requested in children in whom the most likely diagnosis is syncope as the results are potentially confusing and can lead to a misdiagnosis of epilepsy. Martin K et al, Arch Dis Child Educ Pract Ed 2010 Jun;95(3):66-72

A full text link to the updated European Cardiology Society’s syncope guidelines for adults and children is available at http://www.pamw.pl/sites/default/files/PAMW1-2-2010_inv-Sutton_0.pdf .