[The function of autonomic nervous system during paroxysmal events in children and adolescents, and available diagnostic methods].

UNLABELLED: The aims of the study was to establish current knowledge regarding the involvement of autonomic nervous system (ANS) in paroxysmal disorders in children and available diagnostic tools.

MATERIAL AND METHODS: Using key words ANS, epilepsy, syncope and breath-holding spells the search was performed in collections of Elsevier and Springer Journals, as well as MEDLINE/PubMed.

RESULTS: Manifestation of ANS dysfunction may constitute the group of leading symptoms and signs of many diseases, including epilepsy with autonomic attacks and familial dysautonomia. It may however comprise a clinical spectrum coexisting with motor or sensory symptoms and pain. Methods to help diagnose ANS dysfunction at clinical level and to establish its role in pathomechanism diseases include tools analyzing cardiorespiratory changes, especially heart rate variability, during the rest and after functional stimulation, such as orthostatic challenge, Valsalva maneuver and deep breathing as well as methods measuring directly ANS activity, including conduction in autonomic fibers.

CONCLUSIONS: Autonomic nervous system participates in several paroxysmal disorders in children, and maturation of its central structures may influence the course of disease, depending of the child's age. Symptoms of ANS dysregulation may warning as for life threatening conditions, so they should be included as a part of medical history and physical examination. The awareness of connections between ANS and all internal organs is a basis of several additional tests.