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Ann Child Neurol > Volume 25(3); 2017 > Article
Journal of the Korean Child Neurology Society 2017;25(3):156-161.
DOI: https://doi.org/10.26815/jkcns.2017.25.3.156    Published online September 30, 2017.
Orthostatic Hypotension and Postural Orthostatic Tachycardia Syndrome in Children: Comparison of Clinical Features and Neurophysiology Test.
Yun Kyum Kim, Ji Hyun Park, Hee Joung Choi, Joon Sik Kim
Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea. joung756@dsmc.or.kr
Abstract
PURPOSE
The clinical characteristics and neuropsychological tests of orthostatic hypotension (OH) and postural orthostatic tachycardia syndrome (POTS) in children were compared. METHODS: From August 2011 to April 2015, we enrolled patients who visited hospital with dizziness or syncope. According to the results of head-up tilt test (HUTT), the patients were classified into 4 groups; OH group, POTS group, normal group I who had no orthostatic symptom during HUTT, and normal group II who had orthostatic symptom during HUTT. RESULTS: Eighty-eight patients were enrolled with 11(12.5%) in OH group, 13(14.7%) in POTS group, 49(55.7%) in normal group I and 15(17.0%) in the normal group II. During HUTT, the temporal changes of systolic, diastolic, and mean blood pressure of OH group were significantly different from those of POTS group, normal group I, and normal group II. Heart rate changes after tilt showed increase trend in all 4 groups and there was no significant different between OH and POTS group. In normal group II, the temporal changes of diastolic and mean blood pressure were similar to those in POTS group and were significantly different from normal group I. In the autonomic nervous system test, the heart rate response to deep breathing (HRDB) was significantly different between normal group I and II CONCLUSIONS: In pediatric OH patients, heart rate may be increased with blood pressure fall. And if orthostatic symptoms are associated with HUTT, we should not exclude OI even if the test result do not meet the criteria for diagnosis.
Key Words: Orthostatic hypotension, Postural orthostatic tachycardia syndrome, Children
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