[Evaluation of syncope in children with tilt table test]. / Synkopenabklärung bei Kindern mittels Kipptischuntersuchung.

Tilt table testing is a well approached examination for differentiating unexplained syncope and control trial after therapy. It is evaluated at children and is fast and reliable in spite of high personality effort. We present the indication of examination, course of examination, additional procedures like transcranial doppler sonography, reaction models during the tilt table examination and treatment features for neurocardiogenic syncope.

[Value of transcranial Doppler sonography during tilt table test in children]. / Wertigkeit der transkraniellen Dopplersonographie in der Kipptischuntersuchung bei Kindern.

AIM: Transcranial Doppler sonography was used to asses time relation and characteristically changes in middle cerebral artery blood flow velocity before syncope during tilt table test in children. METHOD: We performed tilt table tests in 40 pediatric patients with a medical history for syncope after exclusion of neurologic and cardiologic diseases. Examination was done in a 70 degrees postural position under control of electrocardiogram, blood pressure measurement and measurements of blood flow velocity of middle cerebral artery by transcranial Doppler with 3-MHz probe. RESULTS: In 13 children syncope occurred after 5 to 45 min (average 23.3). 10 of them were neurocardiogenic syncopes. With it diastolic and medium blood flow velocity of middle cerebral artery initial ever increased while resistance and pulsatility index decreased. Just before syncope the diastolic blood flow velocity decreased dramatically thus no diastolic blood flow could be measured, respectively. Almost we could measure no diastolic blood flow just before syncope occurred. CONCLUSION: Patients with neurocardiogenic syncope do have characteristically blood flow velocity changes of middle cerebral artery just before loosing consciousness. Transcranial Doppler is a usefully examination during tilt table. Clear transcranial Doppler results can help to prevent children from the impending syncope.