The Comparison of the Ocular Compression Test and the Tilt-table Test in the Suspected Patient of Vasovagal Syncope in Children and Adolescence
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Purpose : Vasovagal syncope (VVS) is a relatively common disease in children and adolescence. The aim of this study was to compare the tilt-table test (TTT) and the ocular compression test (OCT) in patients who were clinically suspected to VVS. Methods : We searched the medical records of patients who were clinically suspected to VVS during the period from March 2009 to March 2012 at Korea University Guro hospital. Orthostatic hypotension, postural orthostatic tachycardia syndrome and epilepsy were excluded. We also analyzed complete blood test, electrolytes and thyroid function test to exclude other medical conditions that could potentially affect the result TTT or OCT. Results : Forty-six patients who were clinically suspected to VVS were selected. The mean age was 13.6±3.1 years (range, 3.21 years). Fifteen (32.6%) patients were males and thirty-one (67.4%) females. Among the selected patients, eighteen (39.1%) patients were TTT positive and thirty-one (67.4%) were OCT positive. In the McNemar’s test, the P value was 0.02 (P<0.05) which meant there was a difference between two tests to diagnose VVS. In addition, there were 22 patients who were positive for OCT and negative for TTT. During TTT, forty-three (93.5%) patients had to be stopped due to severe symptoms such as nausea, vomiting, dizziness and near fainting, but no patient had any complication during and after OCT. Conclusion : We suggest that OCT is a relatively safe and useful test for diagnosing patients with VVS in children and adolescence in addition to TTT.
Abstract
Purpose : Vasovagal syncope (VVS) is a relatively common disease in children and adolescence. The aim of this study was to compare the tilt-table test (TTT) and the ocular compression test (OCT) in patients who were clinically suspected to VVS. Methods : We searched the medical records of patients who were clinically suspected to VVS during the period from March 2009 to March 2012 at Korea University Guro hospital. Orthostatic hypotension, postural orthostatic tachycardia syndrome and epilepsy were excluded. We also analyzed complete blood test, electrolytes and thyroid function test to exclude other medical conditions that could potentially affect the result TTT or OCT. Results : Forty-six patients who were clinically suspected to VVS were selected. The mean age was 13.6±3.1 years (range, 3.21 years). Fifteen (32.6%) patients were males and thirty-one (67.4%) females. Among the selected patients, eighteen (39.1%) patients were TTT positive and thirty-one (67.4%) were OCT positive. In the McNemar’s test, the P value was 0.02 (P<0.05) which meant there was a difference between two tests to diagnose VVS. In addition, there were 22 patients who were positive for OCT and negative for TTT. During TTT, forty-three (93.5%) patients had to be stopped due to severe symptoms such as nausea, vomiting, dizziness and near fainting, but no patient had any complication during and after OCT. Conclusion : We suggest that OCT is a relatively safe and useful test for diagnosing patients with VVS in children and adolescence in addition to TTT.
참고문헌 (18)
- Fukushige J, "Orthostatic dysregulation, an important threat and a main concern among Japanese low-teenagers", Fukuoka igaku zasshi, 79, pp.106~110 (1988)
- 양은석, "학동기 아동의 Orthostatic Dysregulation의 유병률과 임상증상의 빈도에 대한 연구", Korean Journal of Pediatrics, 48(2), pp.138~142 (2005), 대한소아과학회
- Mathias CJ, "Observations on recurrent syncope and presyncope in 641patients", Lancet, 357, pp.348~353 (2001)
- Newton JL, "Prevalence of family history in vasovagal syncope and haemodynamic response to head up tilt in first degree relatives", Clin Auton Res, 13, pp.22~26 (2003)
- Kim KS, "The clinical characteristics and the usefulness of the ocular compression test in syncope of children test", J Korean Child Neurol Soc, 14, pp.232~242 (2006)
- Bilewicz-Wyrozumska T, "Vasovagal syncope--diagnostic difficulties in adolescents", Wiad Lek, 59, pp.861~865 (2006)
- Khurana DS, "Usefulness of ocular compression during electroencephalography in distinguishing breath-holding spells and syncope from epileptic seizures", J Child Neurol, 21, pp.907~910 (2006)
- Udani V, "Head up tilt test in the diagnosis of neurocardiogenic syncope in childhood and adolescence", Neurol India, 52, pp.185~187 (2004)
- Sheldon R, "A randomized study of tilt test angle in patients with undiagnosed syncope", Can J Cardiol, 17, pp.1051~1057 (2001)
- Fouad FM, "Sensitivity and specificity of the tilt table test in young patients with unexplained syncope", Pacing Clin Electrophysiol, 16, pp.394~400 (1993)
- 윤혜진, "실신 양상을 보인 소아에서 Head-up Tilt Test의 유용성", Korean Journal of Pediatrics, 44(12), pp.1441~1447 (2001), 대한소아과학회
- Zaqqa M, "Neurally mediated syncope", Tex Heart Inst J, 27, pp.268~272 (2000)
- Kaufmann H, "Neurally mediated syncope and syncope due to autonomic failure: differences and similarities", J Clin Neurophysiol, 14, pp.183~196 (1997)
- Eirís‐Puñal J, "Usefulness of the Head‐Upright Tilt Test for Distinguishing Syncope and Epilepsy in Children", Epilepsia, 42, pp.709~713 (2001)
- Jaeger FJ, "Vasovagal syncope: Diagnostic role of head-up tilt test in patients with positive ocular compression test", Pacing Clin Electrophysiol, 13, pp.1416~1423 (1990)
- Brignole M, "Carotid sinus massage, eyeball compression, and head-up tilt test in patients with syncope of uncertain origin and in healthy control subjects", Am Heart J, 122, pp.1644~1651 (1991)
- Leman RB, "Significant complications can occur with ischemic heart disease and tilt table testing", Pacing Clin Electrophysiol, 22, pp.675~677 (1999)
- Vicenzini E, "Combined transcranial Doppler and EEG recording in vasovagal syncope", Eur Neurol, 60, pp.258~263 (2008)
