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Suffering from down syndrome, occasional episodes of vasovagal syncope. Treatment?

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Neurologist, Surgical
Practicing since : 2002
Answered : 173 Questions
My 24 year old daughter with Down Syndrome has occasional episodes of vasovagal syncope. In her lifetime, all episodes (about 6-8 episodes) of vasovagal syncope have occured during or at the end of her monthly menstrual cycle. She's fairly healthy and high functioning for an adult with Down Syndrome. Other than hypothyroidism (she takes a generic synthroid), she takes Paxil and Tricor. She just had another episode of vasovagal syncope, the first time its occured in a year or two. Her Geneticist doc has recommended diet and exercise for weight loss, and we're helping her with this, and she's slowly losing weight.

As far as a preventative treatment, I've heard that oral contraceptives may help ameloriate the heavy cycles and excessive cramping like she's experienced with this cycle she's just finishing (she complains about the cramping and malaise she experiences during "periods", and constantly asks me why she can't take "pills" like some of her friend do to help with "periods"). I plan to have her see her PCP and possibly her gynocologist. What other thoughts or recommendations would you recommend that I mention in an appointment with either of these physicians?
Posted Sat, 6 Oct 2012 in Genetics
Answered by Dr. Vineet Saggar 2 hours later
Dear Friend,

Thanks for posting your query; I have read it in depth.

Definitely your daughter could be having these vasovagal episodes due to severe episodes of dysmenorrhoea, but one aspect that needs due consideration is that around 40 % patients of downs syndrome have basic abnormalities, so this could be a conduction block presenting as syncope, you must see a sociologist and get ECG, echo done followed by electrophysiological testing if required.

Yes, hormonal treatment or OCPs can be used for treatment of dysmenorrhoea but they have to be started under supervision of a gynecologist only.

Please do write back for further discussion.

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