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<p>Sudden loss of consciousness in children is frequently brief and benign but can also indicate a&#xa0;life-threatening pathology. Rapid assessment and a&#xa0;structured management approach are therefore essential. The initial evaluation should follow the ABCDE principles (Airway, Breathing, Circulation, Disability, Exposure), with priority given to identifying and immediately treating life-threatening problems. The level of consciousness (vigilance) can be quickly assessed using a&#xa0;modified pediatric Glasgow Coma Scale or the AVPU mnemonic (Alert, Voice, Pain, Unresponsive). For the systematic differential diagnostics, memory aids such as VITAMINE (poisoning, infection, trauma, alcohol/drugs, metabolic, ischemia, neurologic, endocrine) or I WATCH DEATH (infection, withdrawal, acute metabolic, trauma, CNS pathology, hypoxia, deficiency, endocrinopathy, acute vascular, toxins/drugs, heavy metals) are useful. Key red flags that mandate an expedited diagnostic work-up and, where appropriate, intensive medical care include a&#xa0;cardiac history or exertional syncope, persistent hypotension or bradycardia, hypoxemia, ongoing or prolonged seizures, focal neurological deficits, loss of consciousness lasting more than 5–10 min, fever, and suspected intoxication or recent trauma. Early recognition of these signs guides targeted investigations and timely interventions.</p>

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Differentialdiagnosen und praktisches Vorgehen bei unklarer Bewusstlosigkeit bei Kindern jenseits des Neugeborenenalters

  • 期刊论文

  • 发表日期：

    2026年4月9日

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  • Janina Soler Wenglein,
  • Victoria Lieftüchter

摘要

Sudden loss of consciousness in children is frequently brief and benign but can also indicate a life-threatening pathology. Rapid assessment and a structured management approach are therefore essential. The initial evaluation should follow the ABCDE principles (Airway, Breathing, Circulation, Disability, Exposure), with priority given to identifying and immediately treating life-threatening problems. The level of consciousness (vigilance) can be quickly assessed using a modified pediatric Glasgow Coma Scale or the AVPU mnemonic (Alert, Voice, Pain, Unresponsive). For the systematic differential diagnostics, memory aids such as VITAMINE (poisoning, infection, trauma, alcohol/drugs, metabolic, ischemia, neurologic, endocrine) or I WATCH DEATH (infection, withdrawal, acute metabolic, trauma, CNS pathology, hypoxia, deficiency, endocrinopathy, acute vascular, toxins/drugs, heavy metals) are useful. Key red flags that mandate an expedited diagnostic work-up and, where appropriate, intensive medical care include a cardiac history or exertional syncope, persistent hypotension or bradycardia, hypoxemia, ongoing or prolonged seizures, focal neurological deficits, loss of consciousness lasting more than 5–10 min, fever, and suspected intoxication or recent trauma. Early recognition of these signs guides targeted investigations and timely interventions.