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Arch Pediatr Adolesc Med. 2002;156:945.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Approximately 7% of children with epilepsy experience a particular type of autonomic seizure that is frequently undiagnosed and misdiagnosed.^1-4 Autonomic seizures are more common in children aged 3 to 6 years and are exceptional in adults.⁴ Because autonomic seizures have been largely ignored by pediatrics journals, I am writing this letter in hopes of decreasing the associated avoidable morbidity.^3-4

In autonomic seizures, emetic processes and ictal syncope predominate, although all functions of the autonomic nervous system may be affected.^1-5 Signs and symptoms may include pallor, flushing, mydriasis, miosis, cardiorespiratory and thermoregulatory changes, incontinence, hypersalivation, and diarrhea. Headache, peculiar cephalic sensations, and behavioral abnormalities may also occur.

Autonomic symptoms usually appear first. The fully conscious child often looks pale, complains, "I feel sick," and then vomits. Two thirds of the seizures start during sleep and the child typically wakes up with similar complaints or is found vomiting. Although frank emesis occurs . . . [Full Text of this Article]