The Evaluation and Management of Pediatric Syncope

Syncope is a common problem in children and adolescents. It is typically caused by benign neurally mediated hypotension, but other, more concerning, etiologies of syncope must be considered. In most instances, the underlying cause of syncope in the pediatric patient can be determined by obtaining a thorough history and physical examination. Attention to the cardiac, neurological, and psychological history and examination can rule out more rare causes of loss of consciousness. Most individuals with neurally mediated hypotension can be treated with lifestyle measures including aggressive hydration, dietary salt, and an exercise program. In instances where lifestyle modification fails, medications may offer symptomatic improvement.