Why does my daughter keep fainting?

Vasovagal attacks are the commonest reason for fainting.

They typically occur, for example, in a schoolchild who has missed breakfast, after standing for some time (typically in school assembly) or if faced with an unexpected stressful situation.

During such an attack the child may suddenly feel light headed, sweaty, perhaps nauseated and may describe changes in her vision and look pale and clammy.

She may go on to pass out completely and slump to the floor with brief loss of consciousness and some twitching.

The feeling may pass if she moves around or sits down for a while but she may remember feeling confused and dizzy.

Vasovagal attacks are caused by the vagus nerve being over active. This nerve slows the heart rate down and lowers blood pressure. If it suddenly becomes over active this lead to a rapid drop in blood pressure and heart rate.

As a result not enough blood (and therefore oxygen) gets to the brain. This leads to a brief loss of consciousness.

As soon as your daughter falls down, or if there is time, sits or lies down, her head is at the same level as her heart and blood rapidly flows back into her brain, making her come around.

It is important that someone who has seen your daughter have an attack is able to describe it in detail to her doctor. The story is the best way of making the diagnosis.

However her doctor may also need to examine her heart, blood pressure, and run some blood tests to make sure there is no underlying cause such as anaemia,low sodium or diabetes as such conditions could also make her faint.

Sometimes there can be confusion with fits or convulsion as someone who has a marked vasovagal attack may have jerking limbs which can resemble an epileptic fit.

The story of the episode is vital; in an epileptic fit the child has no memory of the fit whereas in a vasovagal attack the child can recall the events leading up to the faint. She will look very pale and possibly sweaty just before passing out whereas such signs are less common before a fit.

If it is a true fit she might be incontinent or bite her tongue whilst this is unusual in vasovagal attacks.

There are certain precautions your daughter can take in the meantime to avoid vasovagal attacks as they can lead to injuries during the fall as well as being embarrassing.

  • she should not miss breakfast or any meals.

  • when standing still for long periods of time she should keep her legs and calf muscles moving. This makes sure her circulation works well.

  • she should avoid distressing or stressful situations if these are known to make her feel faint. Examples include watching bloody or gory programmes on TV or attending animal dissections.

  • if she needs injections, blood tests or other painful procedures she should be laid flat beforehand and for up to 20 minutes afterwards.

    It is rare for vasovagal attacks to cause any long term problems. They tend to be commonest in the adolescent years probably associated with the hormonal changes of puberty. It is likely your daughter will outgrow them.

    We recommend readers seek personal medical attention in appropriate circumstances.

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