What Caused An Episode Of Unconsciousness In A Child?

Posted on Mon, 24 Apr 2017

Question: my 10 year old daughter was running during PE and fell unconscious. After 20 minutes, she still had not regained consciousness and was transported to the hospital. the first EKG read borderline normal, second one read normal, I'm guessing because they sent us home. No real answers, other than 'syncope'. My concern is the amount of time it took for her to regain consciousness. Should I take her to see a neurologist? or a cardiologist? what would've caused her episode of syncope for such a long duration of time?

Answered by Dr. Ilir Sharka (50 minutes later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that the long duration of loss of conscience could be related to epilepsy seizures.

You should know that the loss of conscience for such a long time is not typical of a cardiac disorders. But, as she was running, a cardiac arrhythmia can not be excluded either, because she has been under a straining physical activity, which imposes a great effort to her heart.

I would like to know if she was confused after regaining conscience. Did she remember anything about the episode?

Confusion after regaining conscience is typical of epilepsy seizures.

But, from the other hand such a long time (more than 20 minutes) in cases of seizures would be considered status epilepticus, which is a very serious medical disorder.

Anyway, considering her age, I would recommend consulting with a neurologist for a careful physical exam, a prolonged EEG and a brain MRI study.

I would also advise performing some blood lab tests:

- complete blood count
- blood electrolytes
- fasting glucose
- thyroid hormone levels.

If all these tests result normal, I would recommend performing a cardiac ultrasound and an ambulatory 24-48 hours ECG monitoring to examine her heart rhythm for a prolonged time.

Hope to have been helpful!

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (20 hours later)

My daughter says the last thing she remembered was the kids cheering her on towards the finish line. She doesn't recall anything after that until she woke up in the ambulance. She looked tired. She complained of a headache and said her legs hurt. She seems fine today and I made an appointment with a pediatric neurologist. Her older brothers suffer from different and rare migraines. one brother has hemiplasia migraines and another, abdominal migraines. Not sure if this information is useful or not. I want to thank you for your input and advice. XXXXXXX

Answered by Dr. Ilir Sharka (6 hours later)

Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Coming to this point, I would explain that she as probably had a seizure. So, consulting with a neurologist would be the right step to follow.

If a neurological disorder is excluded, I would recommend consulting with a cardiologist for a cardiac ultrasound and an ECG Holter monitoring.

Hope to have been helpful!

Wishing all the best,

Dr. Iliri

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar