Objectives: Syncope is a common event in children. The objective of this study was to review the aetiologies and their relative frequencies in the paediatric patients in a general hospital in Hong Kong.

Methods: This is a retrospective study of paediatric patients admitted to our hospital between 1987 and 1996 with a presenting complaint of syncope. Their hospital notes were retrieved and reviewed. The syncopal event and the circumstances together with the clinical assessment as well as the subsequent investigations were analyzed in order to establish the respective aetiology for syncope.

Results: Altogether 146 patients were included in the study. The mean age was 10.4 years. Vasovagal syncope accounted for 54.1% of patients presented with syncope. Seizure disorder accounted for 25.3%, while cardiac cause accounted for another 3 patients (2.1%) with 2 patients having paroxysmal supraventricular tachycardia and 1 patient having frequent hypoxic spells due to complex cyanotic heart disease. In 13.7% of patients, the cause of syncope was unknown. One patient belonging to the seizure group died with autopsy finding revealing diffuse glioma at frontal region.

Conclusions: Syncope is a common presentation in the paediatric population and vasovagal syncope accounts for over half of the cases. Although most cases of syncope are benign, it is important not to miss those cases in whom a life-threatening condition is present.