We Have a Diagnosis

This morning we took Sweet Pea to her appointment with the pediatric neurologist. After I described Sweet Pea's two most recent falling & passing out episodes, the doctor checked her reflexes (they're barely even there! I think he said they call those +1 reflexes - whatever that means) and looked in her eyes, etc.

Then he told us that what I described to him is called Pallid Syncope. At least she has the "Pallid" kind where she turns pale, rather than Cyanotic Syncope, which causes the child to turn BLUE. Eeek!

What happens is that when she hurts herself, and it doesn't even have to be that bad of a fall, Sweet Pea will stop breathing and not enough blood will be in her heart to pump to her head, so she will pass out. For her this is brought on by pain stimulus. It is also normal for kids to make "clonic arm movements" which may look like a seizure, though so far Sweet Pea has not demonstrated that symptom.

Anyway, our family doctor referred us to the neurologist because he was concerned that Sweet Pea may possibly be having seizures, epileptic or otherwise. But the neurologist said that her symptoms match up so neatly to Pallid Syncope that he doesn't believe an EEG is really necessary.

He said that Sweet Pea will experience more of these episodes before they go away, but they will probably be gone by the time she's 5 years old. He also said that unless her symptoms change, he is not worried about the possibility of epilepsy - especially since nobody in either my or Slipshod's families have epilepsy.

Pallid Syncope is genetic. The neurologist asked if either of us had ever had passing out episodes. All of mine have been dehydration related, except for the time I fell flat on my back on a wooden gym floor after not being spotted while doing a flip off a mini trampoline (asshole coach - I told him to spot me!). But that only lasted seconds.

Slipshod, however, had an episode when he was a teenager which also matches the symptoms of Pallid Syncope. His was not brought on by a pain stimulus as Sweet Pea's are - his was brought on by fear because his dad had been bitten by a horse. Once Slipshod was sure that his dad was going to be okay, he went stiff as a board and fell over backward (from standing), then had some jerky arm movements happening. I don't think he was ever diagnosed with anything, but it only happened once.

And apparently Slipshod's mom used to have episodes like this when she was a kid, also brought on by pain.

The neurologist said that the only situations in which Pallid Syncope can actually be life-threatening would be if an incident occurred while Sweet Pea was in the bathtub or swimming pool. But of course we'd be with her and watching her the whole time in either of those situations.

He also said that the best thing to do when she has one of these episodes is to leave her on the floor if that's where she falls, or hold her on her back, and put her legs in the air - just like my sister did the last time this happened. The blood will get to her head faster that way, which will "bring her back" from her passed out state more quickly.

It is also normal for her to want to rest afterward. After every episode she has had so far, Sweet Pea has wanted to nap immediately after she "comes to," but every time I have been afraid that she might have bonked her head hard enough to give herself a concussion so I have made her stay awake at least long enough for me to shine a light in her eyes and make sure they dilate and relax (can't think of the term for that...) correctly. But the neurologist said that these episodes are an exhausting thing for the body to go through, so wanting to sleep afterward is another symptom and should be allowed so that Sweet Pea can recover.

He gave us a copy of an article to read that is almost identical to the link I put above in this post.

While this is a scary thing to deal with as a parent, Slipshod and I are thankful to have a diagnosis that is so clear-cut. We were both concerned that we would see the neurologist and perhaps have tests done and then be told, "she seems normal - we don't know what it is." We're also happy to hear that it will go away!