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

Abstract

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.