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[Importance of tilt-table testing compared with Schellong's test for the diagnosis of orthostatic dysregulations/syncopes]

Sven Jungblut, Hagen Frickmann, Albrecht Römer, Hans Joachim Gilfrich
Medizinische Klinik 2006 March 15, 101 (3): 198-202
16648976

PURPOSE: The study compares the importance of tilt-table testing and Schellong's test for the diagnosis of syncopes.

PATIENTS AND METHODS: In a prospective clinical trial 100 consecutive patients (45 males, 55 females) were included. The index symptom for inclusion was a former syncope or presyncope in the patients' history. The tilt-table testing procedure was performed according to a modified version of the Westminster protocol. Following this procedure, Schellong's test was performed in 83 of the patients.

RESULTS: During tilt-table testing 34 patients suffered from orthostatic dysautonomy with syncope or neuro-cardiogenic syncope. 29 of these symptomatic patients also underwent Schellong's test. However, only four patients showed a borderline positive finding, whereas a clearly positive result was seen in six patients. These patients had shown orthostatic dysautonomies with syncopes during tilt-table testing. No patient suffered from a syncope or presyncope during Schellong's test.

CONCLUSION: Schellong's test is suitable as a diagnostic procedure for orthostatic dysregulation only, and tilt-table testing is highly superior for objectification of the diagnosis and differentiation of syncope.

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