Turkiye Klinikleri Journal of Pediatrics

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Bayılma Şikâyetiyle Çocuk Nöroloji Polikliniğine Gelen Hastaların Değerlendirilmesi: Geriye Dönük Klinik Araştırma
Evaluation of Patients Admitted to Pediatric Neurology Outpatient Clinic with Fainting Complaint: Retrospective Clinical Research
Emine TEKİN a, Betül DİLER DURGUT b, Seyyit Bahaettin ÖNCÜ c
aGiresun Üniversitesi Tıp Fakültesi, Kadın Doğum ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk Nörolojisi ABD, Giresun, TÜRKİYE
bGiresun Kadın Doğum ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk Nörolojisi Kliniği, Giresun, TÜRKİYE
cGiresun Kadın Doğum ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk Kardiyolojisi Kliniği, Giresun, TÜRKİYE
Turkiye Klinikleri J Pediatr. 2021;30(3):205-11
doi: 10.5336/pediatr.2021-82102
Article Language: TR
Full Text
ÖZET
 Amaç: Bayılma şikâyetiyle çocuk nöroloji polikliniğine gelen hastalarımızın etiyolojik olarak değerlendirilmesini amaçladık. Gereç ve Yöntemler: Giresun Üniversitesi Kadın Doğum ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Çocuk Nöroloji Polikliğine Nisan 2018-Şubat 2019 tarihleri arasında bayılma şikâyetiyle gelen hastaların dosyaları geriye dönük olarak incelendi. Demografik verileri, nörolojik, kardiyolojik muayeneleri ve tetkikleri değerlendirildi. Bulgular: Hastaların 136'sının verilerine ulaşıldı. Hastaların 86'sı (%63) kız, 50'si (%37) erkekti. Yaş aralığı 3 ay-18 yaş arasındaydı. Yaş ortalaması 11,2±4,8 bulundu. Yirmi sekiz hasta 5 yaş altı, 35 hasta 5-12 yaş arası ve 73 hasta 12 yaş ve üzerindeydi. Elektroensefalografi 103 hastaya çekildi, 74'ü normal bulundu, 15 hastada jeneralize, 14 hastada fokal epileptik bozukluk tespit edildi. Ekokardiyografi 73 hastaya yapıldı, 47'si normal bulundu, 26'sında ise senkop nedeni olamayacak minör anormallikler saptandı. Hastaların 29'u epilepsi, 27'si vazovagal senkop, 5'i ortostatik hipotansiyon, 7'si katılma nöbeti tanısı aldı. İleri bir merkeze 5 hasta sevk edildi. Psikojenik bozukluk (7 dikkat eksikliği hiperaktivite bozukluğu, 6 anksiyete bozukluğu, 2 konversiyon bozukluğu, 3 depresyon) 18 hastada tespit edildi. Sonuç: Senkop etiyolojisinin belirlenmesinde önemli olan iyi bir anamnez ve fizik muayenedir. Senkop ve konvülziyon ayrımı için ve ciddi patolojilerin tespiti için çocuk nöroloji ve çocuk kardiyoloji konsültasyonları gerekebilmektedir. Bu çalışmada etiyolojide epilepsi ve psikiyatrik hastalıklar daha yüksek oranda tespit edilebilmiştir. Çalışılan merkezin şartlarına göre etiyolojilerde değişiklik olabileceğini belirtmek istedik.

Anahtar Kelimeler: Senkop; çocuk; epilepsi
ABSTRACT
 Objective: We aimed to evaluate patients admitted to the pediatric neurology outpatient clinic with the complaint of fainting etiologically. Material and Methods: The files of the patients who came to Giresun University Obstetrics and Pediatrics Training and Research Hospital between April 2018 and February 2019 with the complaint of fainting were analyzed retrospectively. Demographic data, neurological and cardiological examinations and tests were evaluated. Results: Data of 136 of the patients [86 (63%) female, 50 (37%) male)] were enrolled. The age range was between 3 months and 18 years. Mean age was 11.2±4.8 years. Of them 28 were under 5, 35 were between 5-12 and 73 patients were 12 years and older. Electroencephalography was taken in 103 patients, 74 of them were normal, 15 patients had generalized and 14 patients had focal epileptic discharges. Echocardiography was performed on 73 patients, 47 of them were found to be normal, and 26 of them had minor abnormalities that could not cause syncope. Twenty nineof the patients were diagnosed with epilepsy, 27 with vasovagal syncope, 5 with orthostatic hypotension, and 7 with breath holding spells. 5 patients were referred to an advanced center. Psychogenic disorders (7 attension deficit hyperactivity disorder, 6 anxiety disorder, 2 conversion disorder, 3 depression) were detected in 18 patients. Conclusion: A good history and physical examination are important in determining the etiology of syncope. Pediatric neurology and pediatric cardiology consultations may be required to differentiate syncope, seizures and to detect serious pathologies. In this study, epilepsy and psychiatric diseases were detected at a high rate in etiology. We wanted to state that depending on the center there may be changes in etiologies of syncope.

Keywords: Syncope; child; epilepsy
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