Araştırma Makalesi
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Retrospective characteristics of patients presenting to the pediatric neurology clinic with syncope

Yıl 2022, Cilt: 13 Sayı: 46, 182 - 186, 01.08.2022
https://doi.org/10.17944/mkutfd.1003934

Öz

Objective: The aim of this study is to examine the etiology, clinical features and laboratory parameters of patients who applied to the pediatric neurology outpatient clinic with syncope.
Methods: 107 patients with syncope admitted to the pediatric neurology outpatient clinic of a tertiary education and research hospital between October 2017 and June 2019 were included in the study.
Results: A total of 107 patients, 62 (57.9%) female and 45 (42.1%) males were included in the study. The mean age was 10.54±4.88 years (1-18 years). The mean number of syncope attacks was 2.79±1.09 (1-4). The number of patients who had 3 or more syncopes was higher (57%). There were prodromal symptoms in 45 (42.1%) cases and post syncope findings in 32 (30.2%) cases. Prodromal symptoms are evaluated in order of frequency; motor findings (n=32, 30%), urinary incontinence-motor findings (n=8, 7.5%) and urinary incontinence (n=5, 4.6%). Electrocardiography was pathology in six (5.6%) cases, cranial imaging abnormality was found in nine (8.4%) cases, and epileptiform abnormality was found in the electroencephalography of 21 (19.6%) cases. The three most common causes in the etiology of syncope are vasovagal causes (n=50, 46.7%), psychogenic causes (n=25, 23.4%) and epilepsy (n=21, 19.6%).
Conclusion: The diversity of the etiology of syncope is known. It has been found that recurrent syncope attacks are at the forefront in pediatric neurology outpatient clinic applications, and epilepsy in the etiology of syncope is high compared to the literature.

Kaynakça

  • Feit LR. Syncope in the pediatric patient: diagnosis, pathophysiology, and treatment. Adv Pediatr 1996;43: 469–94.
  • Friedman NR, Ghosh D, Moodley M. Syncope and paroxysmal disorders other than epilepsy. Swaiman’s Textbook of Pediatric Neurology, China; Elsevier, Inc, 2012; 905-925.
  • Bo I, Carano N, Agnetti A, Tchana B, Allegri V, Sommi M, Squarcia U. Syncope in children and adolescents: a two- year experience at the Department of Paediatrics in Parma. Acta Biomed 2009;80: 36–41.
  • Massin MM, Bourguignont A, Coremans C, Comte L, Lepage P, Gerard P. Syncope in pediatric patients presenting to an emergency department. J Pediatr 2004;145: 223–228. https://doi.org/10.1016/j.jpeds.2004.01.048
  • Kanjwal K, Calkins H. Syncope in children and adolescents. Cardiac Electrophysiol Clin 2013;5: 443–455. https://doi.org/10.1016/j.ccl.2015.04.008
  • Driscoll DJ, Jacobsen SJ, Porter CJ, Wollan PC. Syncope in children and adolescents. J Am Coll Cardiol 1997;29: 1039–45. https://doi.org/10.1016/s0735-1097(97)00020-x
  • Kaufman H. Evaluation of the patient with syncope. In: Robertons D, Biaggioni I, Burnstock G, editors. Primer on the autonomic nervous system. 2nd ed. San Diego: Elsevier Academic Press; 2004.
  • Crompton DE, Berkovic SF. The borderland of epilepsy: clinical and molecular features of phenomena that mimic epileptic seizures. Lancet Neurol 2009;8: 370–381. https://doi.org/10.1016/S1474-4422(09)70059-6
  • Uysal F, Bostan ÖM, Çetinkaya F, Deniz T, Çil E. Syncope in Children: Is Rhythm Holter Monitoring Necessary?. J Curr Pediatr 2016;14: 124-128. https://doi.org/10.4274/jcp.32932
  • Öztoprak Ü. Etiology and Neuruological Evaluation of Non-Cardiogenic Syncope in Children. Pediatric Practice and Research. 2019;7(Ek): 111-115.
  • Bozlu G, Durak F, Duman D, Karpuz D, Kömür M, Haliloğlu O. Çocuk Acil Servise Senkop Nedeniyle Getirilen 1020 Olgunun Geriye Dönük Değerlendirilmesi. Mersin Üniversitesi Sağlık Bilimleri Dergisi 2020;13(1): 8-12. https://doi.org/10.26559/mersinsbd.631787
  • Yılmaz Ü, Özdemir R, Katipoğlu N, Dağ T, Berksoy EA, Timur M. Çocuklarda Senkop Etiyolojisi, Nörolojik ve Kardiyolojik İncelemelerin Tanıdaki Değeri. Türkiye Çocuk Hastalıkları Dergisi 2014;8(2): 64-70. https://doi.org/10.12956/tjpd.2014.50
  • Viswanath D, Prabhuji MLV, Menon VV, Kailasam S, Kumar M. Syncope in children. J Indian Acad Oral Med Radiol 2013;25: 294-299.
  • Chen L, Zhang Q, Ingrid S, Chen J, Qin J, Du J. Aetiologic and clinical characteristics of syncope in Chinese children. Acta Paediatrica 2007;96(10):1505-1510.
  • Mohanty S, Kumar CPR, Kaku SM. Clinico-Etiological Profile of Pediatric Syncope: A Single Center Experience. Indian Pediatr 2021 Feb 15;58(2): 134-137.
  • Zavala R, Metais B, Tuckfield L, DelVecchio M, Aronoff S. Pediatric Syncope: A Systematic Review. Pediatr Emerg Care 2020 Sep;36(9): 442-445.
  • Hurst D, Hirsh DA, Oster ME, Ehrlich A, Campbell R, Mahle W T, et al. Syncope in the pediatric emergency department–Can we predict cardiac disease based on history alone?. The Journal of Emergency Medicine 2015;49(1): 1-7.
  • Massin MM, Bourguignont A, Coremans C, Comte L, Lepage P, Gerard P. Syncope in pediatric patients presenting to an emergency department. J Pediatr 2004;145:223–228.
  • Kanjwal K, Calkins H. Syncope in children and adolescents. Cardiac Electrophysiol Clin 2013;5:443–55.
  • Driscoll DJ, Jacobsen SJ, Porter CJ, Wollan PC. Syncope in children and adolescents. J Am Coll Cardiol 1997;29: 1039–45.

Çocuk nöroloji kliniğine senkop şikayeti ile başvuran hastaların retrospektif özellikleri

Yıl 2022, Cilt: 13 Sayı: 46, 182 - 186, 01.08.2022
https://doi.org/10.17944/mkutfd.1003934

Öz

Amaç: Çalışmamızın amacı; senkop şikâyeti ile çocuk nöroloji polikliniğine başvuran hastaların senkop etiyolojisi, klinik özellikleri ve laboratuvar parametrelerinin incelenmesidir.
Yöntem: Ekim 2017-Haziran 2019 tarihleri arasında üçüncü basamak bir eğitim ve araştırma hastanesi çocuk nöroloji polikliniğine senkop nedeniyle başvuran 107 hasta çalışmaya dahil edildi.
Bulgular: Çalışmaya 62’si (%57.9) kız, 45’i (%42.1) erkek olmak üzere toplam 107 hasta dahil edildi. Yaş ortalaması 10.54±4.88 yıl (1-18 yaş) idi. Senkop atak sayısı ortalama 2.79, ortanca 3 (1-4) idi. 3 veya daha fazla sayıda senkop geçirenlerin sayısı daha fazla idi (%57). 45 (%42.1) olguda prodromal belirtiler ve 32 (%30.2) olguda postsenkop bulgular bulunmaktaydı. Prodromal belirtiler sıklık sırasına göre değerlendirildiğinde; motor bulgular (n=32, %30), üriner inkontinans-motor bulgular (n=8, %7.5) ve üriner inkontinans (n=5, %4.6) olduğu belirlendi. Altı (%5.6) olguda elektrokardiyografisinde patoloji, dokuz (%8,4) olguda kranial görüntülemede anormallik, 21 (%19.6) olgunun elektroensefalografisinde epileptiform karakterde anormallik saptandı. Senkop etiyolojisinde görülen en sık üç neden; vazovagal nedenler (n=50, %46.7), psikojenik nedenler (n=25, %23.4) ve epilepsi (n=21, %19.6) idi.
Sonuç: Senkop etiyolojisinin çeşitliliği bilinmektedir. Rekürren senkop ataklarının çocuk nöroloji poliklinik başvurularında ön planda ve senkop etiyolojisinde epilepsinin literatüre göre yüksek oranda olduğu bilgisine ulaşıldı.

Kaynakça

  • Feit LR. Syncope in the pediatric patient: diagnosis, pathophysiology, and treatment. Adv Pediatr 1996;43: 469–94.
  • Friedman NR, Ghosh D, Moodley M. Syncope and paroxysmal disorders other than epilepsy. Swaiman’s Textbook of Pediatric Neurology, China; Elsevier, Inc, 2012; 905-925.
  • Bo I, Carano N, Agnetti A, Tchana B, Allegri V, Sommi M, Squarcia U. Syncope in children and adolescents: a two- year experience at the Department of Paediatrics in Parma. Acta Biomed 2009;80: 36–41.
  • Massin MM, Bourguignont A, Coremans C, Comte L, Lepage P, Gerard P. Syncope in pediatric patients presenting to an emergency department. J Pediatr 2004;145: 223–228. https://doi.org/10.1016/j.jpeds.2004.01.048
  • Kanjwal K, Calkins H. Syncope in children and adolescents. Cardiac Electrophysiol Clin 2013;5: 443–455. https://doi.org/10.1016/j.ccl.2015.04.008
  • Driscoll DJ, Jacobsen SJ, Porter CJ, Wollan PC. Syncope in children and adolescents. J Am Coll Cardiol 1997;29: 1039–45. https://doi.org/10.1016/s0735-1097(97)00020-x
  • Kaufman H. Evaluation of the patient with syncope. In: Robertons D, Biaggioni I, Burnstock G, editors. Primer on the autonomic nervous system. 2nd ed. San Diego: Elsevier Academic Press; 2004.
  • Crompton DE, Berkovic SF. The borderland of epilepsy: clinical and molecular features of phenomena that mimic epileptic seizures. Lancet Neurol 2009;8: 370–381. https://doi.org/10.1016/S1474-4422(09)70059-6
  • Uysal F, Bostan ÖM, Çetinkaya F, Deniz T, Çil E. Syncope in Children: Is Rhythm Holter Monitoring Necessary?. J Curr Pediatr 2016;14: 124-128. https://doi.org/10.4274/jcp.32932
  • Öztoprak Ü. Etiology and Neuruological Evaluation of Non-Cardiogenic Syncope in Children. Pediatric Practice and Research. 2019;7(Ek): 111-115.
  • Bozlu G, Durak F, Duman D, Karpuz D, Kömür M, Haliloğlu O. Çocuk Acil Servise Senkop Nedeniyle Getirilen 1020 Olgunun Geriye Dönük Değerlendirilmesi. Mersin Üniversitesi Sağlık Bilimleri Dergisi 2020;13(1): 8-12. https://doi.org/10.26559/mersinsbd.631787
  • Yılmaz Ü, Özdemir R, Katipoğlu N, Dağ T, Berksoy EA, Timur M. Çocuklarda Senkop Etiyolojisi, Nörolojik ve Kardiyolojik İncelemelerin Tanıdaki Değeri. Türkiye Çocuk Hastalıkları Dergisi 2014;8(2): 64-70. https://doi.org/10.12956/tjpd.2014.50
  • Viswanath D, Prabhuji MLV, Menon VV, Kailasam S, Kumar M. Syncope in children. J Indian Acad Oral Med Radiol 2013;25: 294-299.
  • Chen L, Zhang Q, Ingrid S, Chen J, Qin J, Du J. Aetiologic and clinical characteristics of syncope in Chinese children. Acta Paediatrica 2007;96(10):1505-1510.
  • Mohanty S, Kumar CPR, Kaku SM. Clinico-Etiological Profile of Pediatric Syncope: A Single Center Experience. Indian Pediatr 2021 Feb 15;58(2): 134-137.
  • Zavala R, Metais B, Tuckfield L, DelVecchio M, Aronoff S. Pediatric Syncope: A Systematic Review. Pediatr Emerg Care 2020 Sep;36(9): 442-445.
  • Hurst D, Hirsh DA, Oster ME, Ehrlich A, Campbell R, Mahle W T, et al. Syncope in the pediatric emergency department–Can we predict cardiac disease based on history alone?. The Journal of Emergency Medicine 2015;49(1): 1-7.
  • Massin MM, Bourguignont A, Coremans C, Comte L, Lepage P, Gerard P. Syncope in pediatric patients presenting to an emergency department. J Pediatr 2004;145:223–228.
  • Kanjwal K, Calkins H. Syncope in children and adolescents. Cardiac Electrophysiol Clin 2013;5:443–55.
  • Driscoll DJ, Jacobsen SJ, Porter CJ, Wollan PC. Syncope in children and adolescents. J Am Coll Cardiol 1997;29: 1039–45.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Original Articles
Yazarlar

Hilal Aydın 0000-0002-2448-1270

İbrahim Bucak 0000-0002-3074-6327

Sümeyye Erdoğan 0000-0002-9236-3516

Yayımlanma Tarihi 1 Ağustos 2022
Gönderilme Tarihi 5 Ekim 2021
Kabul Tarihi 5 Nisan 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 13 Sayı: 46

Kaynak Göster

Vancouver Aydın H, Bucak İ, Erdoğan S. Çocuk nöroloji kliniğine senkop şikayeti ile başvuran hastaların retrospektif özellikleri. mkutfd. 2022;13(46):182-6.