Aim: Vagal syncope is a common pediatric problem. Before the age of 6 years, it is not readily recognized by caregivers, often leading to extensive but unnecessary diagnostic evaluation. Our aim was to determine the characteristics of syncope in toddlers and young children and to assess whether this age group was more prone to undergo extensive diagnostic work-up and receive inaccurate etiologic diagnoses.
Methods: we collected clinical data regarding children aged 0-6 years, referred within the years 2007-2014 to our pediatric neurology clinic following one or more episodes of syncope.
Results: We identified 37 children. A family history of syncope was present in 59.5% of cases. A trigger for syncope was identified in 30 of the 37 patients. Most episodes were of short duration and witnesses reported immediate or quick recovery. Most children underwent diagnostic procedures, especially an electroencephalogram (26 out of 37), all tests being normal. None of the children developed epilepsy. Syncope recurred in 22 (59.5%) patients during a two year follow-up.
Conclusions: Vagal syncope in toddlers and young children has similar features to those seen in adolescents and adults, and its diagnosis should be considered following an episode of loss of consciousness with an identifiable trigger for the event and rapid regaining of consciousness, thus avoiding unnecessary diagnostic procedures and hospitalization.
