Table of Contents

HK J Paediatr (New Series)
Vol 18. No. 4, 2013

HK J Paediatr (New Series) 2013;18:217-222

Original Article

The Utility of Head Up Tilt Test with Video Electroencephalography in Children with Recurrent Loss of Consciousness
直立傾斜試驗與視頻腦電圖對兒童復發性意識喪失的效用

E Bayram, Y Topcu, N Yilmaz, P Karakaya, M Kir, U Yis, SH Kurul


Abstract

Aim: We aimed to detect the utility of head up tilt test with video electroencephalography (EEG) in children with unexplained, recurrent loss of consciousness episodes. Method: Video EEG were recorded during the head up tilt test. The test was terminated if syncope or presyncope with 30% decrease in heart rate and/or systolic blood pressure occurred. Regarding encephalography, average amplitudes and frequencies at the baseline, tilt up position, presyncope, syncope and post-syncope period were evaluated from frontal, temporal and parieto-occipital areas. Results: There were 29 children (23 girl, 6 boy), with a mean age 13.83±3.3 years who had at least two syncopal attacks. Head up tilt test combined with video EEG was diagnostic in 12/29 patient (41.4%). 8/12 of the patients developed syncope attack and 4/12 of the patients developed presyncope attacks. Four (33.3%) of the patients with syncope attack had associated involuntary movements (3 vasodepressor, 1 mixed type). In the tilt positive group, there were significant differences in the amplitudes of frontal regions between the baseline and presyncope period (p=0.016 and 0.027, right and left hemispheres, respectively). There were also significant differences in the amplitudes of frontal and parieto-occipital regions and in the frequencies involving the bilateral parieto-occipital regions of the baseline and syncope period (p<0.05). In conclusion, head up tilt test with video electroencephalography is a useful evaluation for children with recurrent vasovagal syncopes and allows systematic description of electroencephalographic abnormalities during the presyncopal or syncopal events.

目的:旨在檢測直立傾斜試驗與視頻腦電圖在原因不明的兒童復發性意識喪失的效用。方法:直立傾斜試驗期間以視頻腦電圖作記錄。如果發生暈厥或先兆暈厥伴心率和或收縮壓降低30%,則終止該試驗。在傾斜位置、暈厥、先兆暈厥及暈厥後,記錄額葉,顳葉和頂枕區的腦電圖基線平均振幅和頻率,並進行評估。結果:共有29名兒童(23名女孩,6名男孩),平均年齡13.83?.3歲,有至少兩次暈厥病史。結合視頻腦電圖和直立傾斜試驗進行診斷,病患12/29例(41.4%)。8/12的患者出現暈厥發作和4/12的患者出現先兆暈厥。4人(33.3%)出現暈厥發作伴不自主運動(3人屬血管抑制型,1人屬混合型)。直立傾斜試驗陽性組,在基線和先兆暈厥期間的額葉區域振幅存在顯著差異(p=0.016和0.027,分別為左,右半球)。同時在基線和暈厥期間的額葉和頂枕區域的振幅和頻率,包括雙側頂枕區域,存在顯著差異(p<0.05)。總之,直立傾斜試驗與視頻腦電圖能有效評估兒童復發性血管迷走神經性暈厥,可提供前暈厥或暈厥發作的腦電圖異常系統性述。

Keyword : Children; Epilepsy; Head up tilt test; Vasovagal syncope; Video electroencephalography

關鍵詞:兒童、癲癇、直立傾斜試驗、血管迷走性暈厥、視頻腦電圖

 
 

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