by clicking the arrows at the side of the page, or by using the toolbar.
by clicking anywhere on the page.
by dragging the page around when zoomed in.
by clicking anywhere on the page when zoomed in.
web sites or send emails by clicking on hyperlinks.
Email this page to a friend
Search this issue
Index - jump to page or section
Archive - view past issues
Chiropractic Journal of Australia : CJA March 2012
26 Chiropractic Journal of Australia Volume 42 Number 1 March 2012 continuously in this pattern from 16 months to the present age (22 months). The maximum period episode free over the preceding 6 months was 3 days. A possible trigger or cause for the onset of the episodes, such as an accident, trauma or infection was denied by the mother. The episodes were not seizure like – there were no tonic/clonic, or any other absence-like characteristics. There were no triggers, such as emotional outbursts, tantrums, or breath holding spells. The systems history was unremarkable, except for “asthma,” occurring with respiratory tract infections, and allergies to nuts (anaphylactic), shellfsh, and dairy. Family history revealed the mother had a history of epilepsy, with seizures from 19 years, but none in the past 5 years. Developmental history was unremarkable. MC had achieved her fine and gross motor milestones at the appropriate times. There were no sleep diffculties. Her language development was appropriate. The pregnancy history was unremarkable. The birth was via emergency caesarean at 36 weeks, followed by 9 days of naso-gastric feeds, due to poor early weight gain. In infancy she was diagnosed with “refux,” treated with Losec, and fed with Neocate (prescription formula). Medical investigation at a paediatric hospital included history, physical examination, EEG, ECG, brain and brainstem MRI. A probable diagnosis of neurogenic (vaso- vagal) syncope was made, and the mother was told that no medical treatment was available. At 22 months of age, a chiropractic examination was conducted. MC was non-compliant throughout the examination. Therefore, it was possible to complete a focused examination only. PAEDIATRIC SYNCOPE MANAGEMENT STEWART Table 1 Study Sample Ages Results Gordon et al, 19871 73 2.5-20 Pathology in 7 including: Myocardial disease Atrioventricular node reentrant tachycardia Pratt et al, 198949 40 Children and Vasovagal sycope (50%) Adolescents Orthostatic hypotesion (20%) Atypical seizure (7.5%) Migraine headache (5%) Minor head trauma (5%) Driscoll, 19974 151 Mean 16 years Vasovagal (40%) Simple faint 29%) Psychogenic, breath holding, concurrent infection, possible epilepsy, orthostatic, hyperventiliation, hypoglycemia, unknown Massin, 200445 226 0-16 Neurocardiogenic syncope (80%) Neurologic disorders (9%) Cardiac disorders (2%). Others: psychologic, cardiac, respiratory, toxicologic, and metabolic Bo, 20095 154 1to18, Cardiovascular syncope (77.5%) Mean age 10.5 - 7 cases refex - 4 secondary to orthostatic hypotension. Neurological syncope (20%), Metabolic syncope (1.25%). 15/156 were pathological - 3 cases due to arrhythmia - 9 due to epilepsy. Di Mario, 201151 141 Mean age, Neurocardiogenic syncope in 78% 12.01 Syncopal convulsions - 38% Epilepsy in 2.8%
CJA June 2012