Neurocardiogenic syncope and epilepsy in pediatric age: The diagnostic value of electroencephalogram-electrocardiogram holter

Mario Mastrangelo, Rosanna Mariani, Fabiana Ursitti, Laura Papetti, Paola Iannetti

Research output: Contribution to journalArticlepeer-review

Abstract

Neurocardiogenic syncope is induced by a hyperrecruitment of parasympathetic nerve tone elicited by emotional stress or pain. The presence of a transient loss of consciousness associated with involuntary motor activity or with urinary incontinence and the misinterpretation of anamnestic data or of electroencephalogram (EEG) abnormalities often leads to wrong diagnosis of epilepsy in children with this disorder.Careful and systematic history taking, pressure measurement, electrocardiogram (ECG), and, in selected cases, head-up tilt table testing are generally enough to rule out a cardiogenic or a neurocardiogenic syncope. Simultaneous EEG-ECG Holter represents a useful instrument for differential diagnosis between neurocardiogenic syncope and epilepsy.We report 3 case reports to demonstrate how simultaneous EEG-ECG Holter can contribute to characterize functional heart-brain interactions and the exact sequence of the physiopathologic events leading to the loss of consciousness in cases in which the clinical borders with epileptic disorders are particularly subtle.

Original languageEnglish
Pages (from-to)36-39
Number of pages4
JournalPediatric Emergency Care
Volume27
Issue number1
DOIs
Publication statusPublished - Jan 2011

Keywords

  • EEG-ECG Holter
  • epilepsy
  • head-up tilt table testing
  • Neurocardiogenic syncope

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

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