title: Pediatric autonomic testing: retrospective review of a large series.
abstract: OBJECTIVE. To describe the reasons for referral, autonomic diagnoses, test results, and patient management in a large pediatric population referred for testing for an autonomic disorder. DESIGN. The authors reviewed autonomic testing data and medical records for patients aged 18 years and younger who underwent testing between 1993 and 2007 and who had adequate clinical data. Relevance of test results to clinical symptoms was ranked on a 3-point scale. Treatments were noted and their benefit ranked on a 5-point scale. RESULTS. Among 142 pediatric patients identified, postural tachycardia syndrome was most common (71%) while orthostatic hypotension was rare (5%). Testing provided relevant information regarding the patient's symptoms in 88% of the cases. Beta-blockers were the most commonly prescribed medication (59%); 73% improved. CONCLUSIONS. Postural tachycardia syndrome was common in this large pediatric population, whereas orthostatic hypotension was infrequent. The symptomatic improvement in the majority bears an unclear relationship to treatment. Prospective studies are needed.
authors.affiliation: University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Devraj
authors.initials: D
authors.lastname: Sukul
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Chelimsky
authors.forename: Gisela
authors.initials: G
authors.lastname: Chelimsky
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D007223:Infant; D008297:Male; D054972:Postural Orthostatic Tachycardia Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists