Crying syncope

Introduction Crying and fainting: Also known as breath-holding spells, commonly known as "gas death", found in children aged 1 to 4. Often caused by pain, being scolded or scared. When the child burst into tears, he held his breath, his face was bruised, his consciousness was lost, and he quickly woke up after a few seconds or ten seconds. Misdiagnosed as epilepsy. After 3 to 4 years old, it will not be sent.

Cause

The classification of the cause of syncope is not uniform. The syncope is generally divided into different types depending on the disease. include:

1 vasomotor disorder syncope.

2 cardiogenic syncope.

3 brain-derived syncope.

4 drug-induced syncope.

5 metabolic syncope.

6 Syncope caused by physical factors.

7 other.

an examination

Related inspection

Brain CT examination brain MRI examination EEG examination brain nerve examination

The physical examination of patients with syncope focuses on the cardiovascular system, paying attention to changes in blood pressure in the supine and upright positions, differences in blood pressure on both sides, pulse, heart rate, heart rate, and heart murmur.

Fecal occult blood test can help to understand whether there is gastrointestinal bleeding, and it is meaningful to identify the cause of orthostatic syncope. Blood tests may be helpful for patients with bleeding. Low glycemic, hyponatremia, hypocalcemia or renal failure can be seen in a small number of patients with syncope. Autonomic function tests sometimes help detect the neurological causes of orthostatic hypotension, such as serum catecholamine and dopamine-beta hydroxylase levels in the supine and upright positions, and if there is no change, suggest idiopathic orthostatic hypotension or Autonomic neuropathy.

Electrocardiogram is important for diagnosing arrhythmia and myocardial ischemia; echocardiography can detect various cardiac structural abnormalities.

Differential diagnosis

Syncope needs to be distinguished from dizziness, dizziness, collapse, epilepsy, shock, and coma.

1. Dizziness refers to the feeling of dizziness, often accompanied by vertigo, body shaking, and no consciousness disorder.

2. Vertigo is a subjective error in the patient's alignment (space-oriented sensation). The patient consciously rotates or moves to one side, or feels that he is spinning, shaking, or rising and falling. Patients are often described as "spinning", "unsteady footsteps", "such as riding a boat", "skewing to one side" and so on. But the consciousness is clear, mostly the performance of vestibular neuropathy (Table 1).

3. Seizure is caused by abnormal discharge caused by increased excitability of brain nerve cells. At the time of seizures, the regional cerebral blood flow and the oxygen metabolism rate of the brain not only decrease, but greatly increase, and therefore, the essence of syncope is completely different. Although patients have different clinical manifestations due to different discharge sites, modes of transmission and range of lesions, they are often accompanied by loss of consciousness, and are characterized by sudden, temporary and repetitive features, which should be distinguished from syncope. For suspicious patients, the patient and family members or those who are on the sidelines of the patient's episode should be informed about the episode and a detailed physical examination to determine whether it is epilepsy. Epileptic seizures are often accompanied by persistent systemic muscle contractions with more characteristic manifestations, and it is not difficult to determine the diagnosis.

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