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Health Issues

Syncope (Dizziness and Fainting Spells)

A temporary decrease in blood flow to the brain results in unconsciousness, or fainting. Many disorders, some of them serious, can cause this. “In adolescents,” says pediatric neurologist Dr. Patricia Crumrine of the University of Pittsburgh Medical Center, “fainting usually turns out to be due to vasovagal syncope.” Your pediatrician may also refer to it as neurally mediated syncope. The condition is not serious, although a child can incur head injuries and lacerations from collapsing. Syncope can be set off by pain, fatigue, heat, exercise, stress—even intense emotions, like the shock of hearing some distressing news or watching a scary scene in a movie. In response, the heart contracts more forcefully than usual. The nervous system, sensing this, overreacts. It slows down the pumping action, inducing a sudden drop in blood pressure. At the same time, it narrows major blood vessels, including those that carry blood to the brain. Typically, young victims regain consciousness after a few minutes, with no lingering effects, and have full recall. 

Symptoms of Syncope

Sudden light-headedness, followed by loss of consciousness and collapse.

How Syncope is Diagnosed

  • Physical examination and thorough medical history
  • Tilt-table test

Vasovagal syncope runs through many family trees. “When we take the patient’s family history,” says Dr. Crumrine, “we often find that a close relative experienced similar symptoms at around the same age.” A diagnosis can frequently be reached just on the basis of the history and possibly a tilt-table test. This simple, noninvasive procedure entails strapping a young patient to a mechanical table, then tilting it up to a near-standing position. She remains at this angle for ten to fifteen minutes. Fainting brought on by a rapid drop in blood pressure and heart rate is considered a positive result for vasovagal syncope. Rest assured that once the table is lowered, the patient’s heartbeat and circulation return to normal, and she regains consciousness. The physician may order a variety of additional tests to rule out other conditions, such as seizures (epilepsy) and cardiac disorders. 

How Syncope is Treated

  • Dietary measures: Teenagers who are prone to fainting tend not to eat the recommended daily allowance of two thousand to three thousand milligrams of salt. While a diet high in sodium can eventually lead to hypertension, too little salt isn’t healthy either, for two of the mineral’s functions are to regulate blood pressure and retain fluid in the circulation. Children often do not take in enough fluid. This, too, contributes to vasovagal syncope. Your youngster should be drinking the equivalent of at least eight cups of water and other fluids per day.
  • Drug therapy: If medication is used, one of three drugs is typically called on to control the symptoms of vasovagal syncope. Fluorocortisone, a mineralo corticoid steroid, compels the kidneys to recirculate dietary salt instead of excrete it in the urine. Potassium is sacrificed instead; accordingly, a potassium supplement is often added when young patients begin the medication. Atenolol works by way of an entirely different mechanism. The beta-blocker decelerates the heartbeat and prevents the powerful contractions that switch on the fainting reflex. Disopyramide, too, decreases the strength of the contraction, but it belongs to two different groups of agents: antiarrhythmics and anticholinergics. 

Helping Teenagers Help Themselves

The measures below can help teens who are prone to fainting reduce the frequency of future episodes:

  • Learn to recognize the early signs of a faint. A full swoon can be prevented by placing the head between the knees or by lying down.
  • Minimize the amount of time spent in warm environments, such as showers and baths, and a hot midday sun. Saunas, hot tubs and Jacuzzis are to be avoided.
  • When you are standing for long periods of time, shift your weight and flex your leg muscles, to keep the circulation moving. Even subtle movements, like bending forward from the waist, aid blood flow to the brain.
  • When sitting for extended periods of time, sit in a low chair, lean forward with your hands on your knees or bring your knees up to your chest.
  • Use pillows to elevate the head of the bed slightly.
  • Avoid alcohol, which causes veins to widen, further reducing blood pressure. 

What to Do if a Youngster Faints 

  • If you can, try to catch him before he hits the floor.
  • Gently lay him down on his back.
  • If he has food in his mouth, lay him on his side with his face turned to the floor.
  • Do not attempt to rouse the youngster with ammonia or ammonia capsules, or by dousing him with cold water or slapping his cheeks. He should come to on his own within several minutes.
  • Inform your pediatrician. 

Other Causes of Fainting in Teens

Two other common causes of dizziness and fainting in young people are hyperventilation  and orthostatic hypotension. “Orthostatic” means “caused by standing erect”; “hypotension,” “low blood pressure.” Adolescents with this condition may feel dizzy and weak if they stand up too quickly from a prone position. The drop in blood pressure is related to pubertal growth causing a rapidly rising center of gravity and expanding blood volume.

 

Last Updated
3/31/2014
Source
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.