Table 1

Clinical data on 27 children with a history of AES

Case no./sex/from	Ref./case	Syncope onset (mth)	Syncope type/frequency	AES onset (mth)	Epileptic component/duration (min)	Evidence of epileptic component	AES total	Therapy (bold type = effective)	Other epileptic seizures	Other details/FH
All cases were referred from the west of Scotland, except those initialled in the first column as: S, from elsewhere in Scotland; E, from England; W, from Wales, U, from USA. In the second column Ref./case gives the reference and the published case number (if any).
Syncopes are abbreviated: RAS, reflex anoxic seizures/reflex asystolic syncope; PEA, prolonged expiratory apnoea (cyanotic breath-holding); BHS, breath-holding spells of uncertain mechanism or combined asystole and expiratory grunting; VVS, vasovagal syncope of adult type; CVM, compulsive Valsalva manoeuvre.
Under Evidence of epileptic component, the scoring of level of evidence is as in box 1, with “seen in ward”, observed during ward-round; “that’s it!”, recognition of event by parents from video demonstrations;²⁰ and “1/s jerks”, parents described and mimed 1/second jerking.
In Other epileptic seizures: FS, febrile seizures; FS+, febrile seizures plus.
In the last column: FH, family history; M, mother; m, month; the figures before s., seconds refer to duration of asystole; OC, ocular compression; CM, cardiac monitoring; tilt, head-up tilt testing.
Other abbreviations are as previously, except that when PEA is followed by a number of seconds, that is the duration of asystole accompanying the PEA event.
1 M	¹	6–7	RAS	15	Clonic	1	3	–	–	OC 22s
	11.1		3/day		10
2 M	¹	9	RAS	11	Clonic	1	2	–	–	OC 30 s
	11.2		Several		½
					(28s.)
3 F		15	RAS	48	Focal	1	1+	Carbamazepine	Same	OC 17 s
			1/month		3
4 M	¹¹	0.5	BHS	7	Myoclonic absence	2c	Many	Clonazepam	Same
	5		3/week		1
5 M U	¹¹ 3	30	CVM Daily	30+	Clonic (vibratory) ¾	2a	Many	Wrestler’s belt Naltrexone	–
								Diazepam
6 M	¹¹ 4	5	PEA Daily	10	Clonic 1	2b	Many	Iron Piracetam Psychology Valproate	–	Brother PEA & FS up to 20 m
7 F		30	VVS	84	Clonic	4b	1	–	–	Ear piercing
			Total 2		5					Ear piercing
8 F		6	RAS	18	Clonic	4a	10	–	–	CM 31 s
			3/day		25
9 F	¹	4	PEA	14	Clonic	3	20	–	–	OC 5 s
	8.1		3/day		5	Seen in ward
10 F	¹	6	BHS	11	Clonic	4a	>3	–	–	OC 12 s
	15.45		2/week		20					One AES febrile
11 F	²	8	PEA	15	Clonic	4b	4	–	–	OC 7 s
	2		Daily		3					PEA 8 s
12 F		42	RAS	108	Clonic	4a	1	Pacing	–	Tilt 30 s
			3/month		15
13 M W		12	BHS 1/month	17	Clonic 30	3	3	Diazepam Valproate	–	OC 1.5 s Sister FS with status
14 F	¹	12	RAS	<20	Clonic	3	1	Diazepam	–	OC 28 s
E	4.8		Total 12		15
15 F		8	BHS	13	Clonic	4b	3	–	–	OC 2 s
			6/year		1	“That’s it!”
16 F S	¹⁵7	0.2	RAS 4/day	19	Clonic 40	3	1	Diazepam Paraldehyde Valproate	–	CM 20 s
								Pacing
17 M	¹	9	PEA	18	Clonic	4b	3	–	–	OC 0 s
	11.3		Daily		2
18 F	¹	<16	BHS	16	Clonic	3	2	Diazepam	–	OC 15 s
	11.4		Total 3		20
19 M		9	PEA	17	Clonic	4b	4	–	–
			Daily		2	“1/s. jerks”
20 F		120	VVS	120	Clonic	3	3	Diazepam	–	Hair groom
			Total 3		10					M: epilepsy
21 F	¹	12	RAS	18	Clonic	3	1	Diazepam	–
	11.5		5/year		30			Repeat needed
22 F		4	BHS	<30	Clonic	2c	6	Valproate	Same, also FS = FS+	M’s sister FS
22 F		4	Total 13	<30	1	2c	6	Valproate	Same, also FS = FS+	M’s sister FS
23 M		8	RAS	15	Clonic	4b	6	Carbamazepine	–
E			Up to 5/day		5
24 F		8	BHS 3/week	11	Clonic + absence status	3	1	Diazepam	–
					30
25 M		14	BHS	20	Clonic	4b	1	–	–
E			3/week		5
26 M		0.6	PEA	12	Clonic	4a	10	Phenobarb.	–	OC 0 s
			Uncertain		15
27 F	¹⁴	8	BHS Up to 40/day	12	Clonic 2	1	Up to 3/day	Valproate Carbamazepine Atropine, Pacing	–	OC 24 s
E										PEA 23 s
										Twin RAS