Pediatric Heart Expert Forum
Recurrent syncope in child
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Recurrent syncope in child

My dtrs first syncopal episode with seizure like movements was at age 4.  She was ill with a fever, so docs felt it could be febrile seizure.  She has experienced several years of recurring loss of consciousness, but revives in a few minutes. Most times she had episodes while vomiting.  She always lies down to prevent falls.  After taking milk out of her diet, the frequent vomiting stopped and the fainting episodes seemed to stop.....for awhile.  Then, four weeks ago she was in her bedroom and cut herself accidentally with a pair of scissors...she went out.  She doesn't know how long she was out.  She was confused and pale.  Just this past Monday, she fell in the bathroom after a pain episode caused by soap in her eyes, and did not respond for a couple of minutes, she was behind a locked bathroom door, and just before we broke open the door, she answered our calling to her, and she was able to get to bed and lie down. She hit her head on the tile floor.  About 1/2 hour later, she vomited 2 more times and lost consciousness again for about 30 seconds.  Our PCP sent her to the ER.  On the cardiac monitor she had normal heart rate.  Her EKG was negative.  When she stood up from the stretcher, her HR increased to 151, but she had no symptoms and did not faint.  We are trying to figure this all out.  Back when this all started, she had normal heart echo, EEG, and mri.  She has increased salt in her diet, and increased fluids.  I am concerned that maybe her 'benign syncope' could actually be a channelopathy such as CPVT.  I'd so much appreciate some guidance.  If a channelopathy could be detected with simple stress testing or adrenaline testing, that would be wonderful.  My dtr is now 12 1/2 years old, a very good student.  This has been a trying and scary mystery.  She has relatives with fainting hx's and one cousin with WPW
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It sounds like your child has had a good work up.  the events sounds vagally mediated and she may have long pauses (cardio-inhibitory syncope).  She should wear a long term monitor to try to capture and episode and document how low her heart rate goes.  Rarely a pacemaker is used in problematic cases to try to prevent loss of consciousness.  It is not likely CPVT as that occurs with activity. If her ECG is normal she likely does not have a channelopathy.  You should seek the advise of an electrophysiology specialist (EP).
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This is, indeed, the premise we are following.  My dtr had a negative stress test, which is very reassuring.  A 24 holter monitor result is pending.  Thank you so my for your thoughts about my concerns!  
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