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Avatar universal

15yr old daughter diagnosed with Vasovagal Syncope

My daughter is a freshman in high school.  Healthy, involved in sports, active.
On 2/7/14 she was a volunteer at the Red Cross blood drive at school, and upon watching her older sister donate blood, she became faint and had to lay down.  She did not lose consciousness; just was weak and lightheaded.
Two days after that episode, she fainted during cheer practice.  This has now been occuring approximately every 2 days only while she's at school.  

She's had 2 EKG's (normal), bloodwork normal, EEG just done, waiting on results.  We've increased breakfast (not just the granola bar while flying out in morning), increased salty snacks and water/Gatorade consumption.  She will pass out during class, at times from 4-10 minutes out cold.  Same symptoms every time; she feels heart begin to race, feels nauseous and gets hot, knows she is ready to faint and able to alert classmate/teacher so she gets down low.  

I'm perplexed at the vasovagal syncope diagnosis. We are having meeting with school prinicpal/nurse/guidance today as we need to come up with a plan that will work; maybe 1/2 days at school for a week to see if she can get away from the syncope episodes?  This is obviously embarrassing for her, she hates this and is worried about when she will pass out.  It also is disruptive I'm sure to school staff; I know its freaked out a few.

She is wearing the Holter cardiac monitor and we record the episodes, but so far, "everything is within normal limits."

Her PCP suggested therapist to talk to about her anxiety and feelings of worry about passing out, which we have scheduled.

Upon coming out of a syncope episode she is tired and has a left temporal lobe headache she classifies around a 6.   It eases off within an hour - sometimes Ibuprofin is given.

Thoughts?  Hormones?  
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Avatar universal
Sorry to hear about this. The first episode associated with seeing a blood draw definitely sounds like a vasovagal episode. While the others certainly may be that as well I think it is necessary to evaluate for other causes as well. I agree with seeing a neurologist as seizures and atypical migraines can both lead to similar episodes that you are describing. I would also see a cardiologist to evaluate for cardiac causes of syncope. In addition to a Holter monitor (which as I am sure you know is only helpful if she has an episode when wearing it), I would also get an echocardiogram as well as possibly a tilt table test. I know this must be a difficult time but I wish you the best and hope that your daughter gets some relief.
Helpful - 1
Avatar universal
You may want to have her checked for Chiari Malformation. A MRI would detect it.
Helpful - 0
Avatar universal
I am glad your daughter's EEG turned out to be normal, and as the medhelp doctor suggested, it's good that a tilt-table test has been scheduled.

However, if the tilt-table test is negative, before concentrating on anxiety as the sole cause of the fainting, please follow up on the advice of the doctor here and google terms like 'syncopal migraine' and 'migraine with syncope.'   The reason is that there is evidence of a pretty strong correlation between migraine and fainting, and several factors in your daughter's history warrant further investigation of this.  

One of the recent pubmed articles you will read (the one whose primary author is Curfman D) if you google 'syncopal migraines' points out that people with this condition stay unconscious for longer than usual, and your daughter's 4-10 minutes out cold is very long indeed.  Further, *any* one-sided headache--such as your daughter experiences after fainting--is really, really suspect.

Please keep us up to date.
Helpful - 0
Avatar universal
Yes, EEG was normal and read by a pediatric neurologist yesterday 3/10/14.  The neurologist ordered a tilt-table test which we will have 3/13/14.  If there are no cardiac/blood pressure abnormalities from that, she is pointing this all towards my daughters anxiety.  Medically, everything else is normal.  They even did more bloodwork and tested for other items.
My daughter does suffer from anxiety and is taking Zoloft (50mg).  She said she feels stressed @ school, where all these episodes are occuring, because she has missed so much and is behind.  Lots of late assignments and missing work.  We are working with school and have adapted her schedule to allow for the most non-stress make-up (added a study hall with extra help from teacher).
Icing on cake though - she came down with stomach flu yesterday and is home today.  :-(

Appreciate your comments!  This has been a scary thing and I'm a worry-wart - I feel my anxiety peaking always waiting for that "call" from school.

Helpful - 0
Avatar universal
You say your daughter has had an EEG.  Has she been seen by a neurologist?
Helpful - 0

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