Neurocardiogenic syncope in children : current concepts in diagnosis and management.
A wide variety of pharmacologic agents are currently used for the prevention of recurrent neurocardiogenic syncope in children and adolescents. Significant advances in the understanding of this syncopal disorder have occurred in the past decade, and the list of medications recommended has changed, reflecting the evolving understanding of the pathophysiology and development of agents with enhanced efficacy and fewer adverse effects. Clinicians have few randomized controlled trials available to guide their decisions about treating neurocardiogenic syncope, and even fewer when it comes to medications targeting the pediatric population. At the present time, beta-adrenergic receptor blockers, fludrocortisone, and also specific serotonin reuptake inhibitors and midodrine, appear to be favored treatment options. Ideally, specific therapy would be tailored to specific pathophysiologic mechanisms. Unfortunately, at present, specific treatments based on those abnormalities have not been identified.
Massin
Martial
M
Division of Pediatric Cardiology, University of Liège at Regional Hospital Centre La Citadelle, Liège, Belgium. martial.massin@chrcitadell.be
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D005438:Fludrocortisone / Q000627:therapeutic use*; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology
D000319:Adrenergic beta-Antagonists; D000893:Anti-Inflammatory Agents; D005438:Fludrocortisone; D017367:Selective Serotonin Reuptake Inhibitors