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Clinical Pediatrics, Vol. 43, No. 1, 17-23 (2004)
DOI: 10.1177/000992280404300103
© 2004 SAGE Publications

Autonomic Syncope in Pediatrics: A Practice-Oriented Approach to Classification, Pathophysiology, Diagnosis, and Management

Samuel O. Sapin, MD

Department of Pediatrics, Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles; Department of Pediatrics, Southern California Permanente Medical Group, Panorama City, CA

This paper presents a practice-oriented approach to the problem of syncope in pediatrics. Autonomic syncope is the major etiologic category in pediatrics and consists of 2 types: reflex and dysautonomic. The latter type is rare in pediatrics. Reflex syncope has 4 subtypes: neurocardiogenic, central, situational, and cerebral. Neurocardiogenic syncope, the most common subtype, is easily diagnosed by taking a careful, detailed history; identifying diagnostic red flags; performing a complete physical examination; and ordering a minimum of laboratory tests. Patient and parent education is essential, and usually, without medication, outcomes are good.


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