REVIEW ARTICLE


Neurally Mediated Syncope in Children and Adolescents: An Updated Narrative Review



Rose Mary Ferreira Lisboa da Silva1, 2, *, Pamela Michelle Leite Oliveira2, Henrique Assis Fonseca Tonelli2, Zilda Maria Alves Meira2, Cleonice de Carvalho Coelho Mota3
1 Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
2 Cardiology Unit, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
3 Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil


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Creative Commons License
© 2022 Lisboa da Silva et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Internal Medicine - Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Avenue Alfredo Balena, 190, room 246, Centro, Code 30.130-100, Belo Horizonte, Minas Gerais, Brazil; Tel: + 55313409-9746; E-mail: roselisboa@uol.com.br


Abstract

Syncope presents a proportion of up to 25% among children and adolescents and accounts for 0.9% of emergency room visits. Its most frequent aetiology is neurally mediated syncope, which includes vasovagal syncope and orthostatic hypotension. Up to 70% of the paediatric population with reflex syncope is female. There are usually precipitating factors and prodromes. This mini-review will discuss the particularities of the clinical presentation, diagnosis, modified Calgary score, indications and accuracy of the head-up tilt test, classification, and pathophysiology in four sequential phases. Prognostic data and the non-pharmacological and pharmacological approaches will also be reviewed and differences regarding reflex syncope in adults will be discussed.

Keywords: Neurally mediated syncope, Paediatric syncope, Vasovagal, Calgary score, Head-up tilt test, Adolescents.