Abstracts

Rationale: The workup of prolonged or recurrent and unexplained syncopal episodes is an exceedingly expensive and difficult one for providers, families, and patients alike. There has been much research dedicated to showing how electroencephalography (EEG) is a poor investigation for typical syncope, but recent research in adults suggests cases of psychogenic syncope examined with video EEG do not show the typical EEG changes associated with organic syncope. We sought to examine any related findings in the pediatric population.Methods: A retrospective chart review for patients aged 8- to 18-years-old diagnosed with psychogenic syncope seen in the last two years in whom also received video EEG en route to their diagnosis were included. Video EEG findings were recorded as well as patient age, sex, and presenting features of syncope.Results: Four patients were identified and included. Patient ages ranged from 14- to 18-years old, and three of four patients were female. Syncopal events were induced and recorded during video EEG, typically via hyperventilation. These events were analogous to their typical syncopal episodes. The EEG did not show any slowing or suppression of baseline activity in any patient, which is inconsistent with organic syncope. The diagnosis of psychogenic syncope was therefore made in each patient.Conclusions: The use of video electroencephalography could play a vital role in elucidating a clear diagnosis of psychogenic syncope, mitigating the need for further investigations when attempts to aggressively reproduce the syncopal events are made. The significance of the findings suggest that video EEG can establish a clear diagnosis of psychogenic syncope in suspected cases in the adolescent-aged pediatric population, thereby providing the opportunity to dispel and discourage future events and provide a sense of closure to both patient and family as appropriate counseling and treatment may be approached.