Navigation Links
Breath-holding spells


Breath holding spells are episodic occurrences that usually result in apnea, loss of consciousness, and changes in postural tone.

Breath holding spells occur in approximately 5% of the population with equal distribution between males and females. They are most common in children between 6 and 18 months and usually not present after 5 years of age. They are unusual before 6 months of age. A positive family history can be elicited in 25% of cases. It is often confused with epilepsy.

There are two types of breath holding spells. Cyanotic breath-holding spells are usually precipitated by anger or frustration although they may occur after a painful experience. The child cries and has forced exhalation leading to cyanosis (blue in color), loss of muscle tone, and loss of consciousness. The majority of children will regain consciousness and be fine within a minute or two, but some will fall asleep for an hour or so. Physiologically, there is often hypocapnea (low levels of carbon dioxide) and usually hypoxia (low levels of oxygen). The events are thought to occur due to a variety of factors, including the fact that the child is not breathing, there is increased intrathoracic pressure secondary to the Valsalva maneuver, and decreased cardiac output. This eventually leads to a significant decrease of circulation to the brain and ultimately, loss of consciousness. There is no "post ictal" phase (as is seen with seizures), no incontinence, and the child is fine in between spells. Electroencephalograms (EEG's) are normal in these children. There is no relationship to the development of seizures or cerebral injury.

With the second type, known as "Pallid" breath-holding spells, the most common stimulus is a painful event. The child turns pale (as opposed to blue) and loses consciousness with little if any crying. The EEG is also normal, and again there is no post ictal phase, nor incontinence. The child is usually alert within a minute or so. There may be some relationship with adulthood syncope in children with this type of spell.

A third type, known as "complicated" breath-holding spells, may simply be a more severe form of the two most common types. This type generally begins as either a cyanotic or pallid spell that then is associated with seizure like activity. An EEG taken while the child is not having a spell is still generally normal.

The diagnosis of a breath holding spell is made clinically. A good history including the sequence of events, lack of incontinence and no post ictal phase, help to make an accurate diagnosis. Some families are advised to tape the events to aid diagnosis. An electrocardiogram (ECG) may rule out cardiac arrhythmia as a cause. There is some evidence that children with anemia(especially iron deficiency) may be more prone to breath holding spells.

The most important treatment is reassurance to the family, because witnessing a breath-holding spell is a frightening experience for observers. There is generally no treatment available or needed for breath holding spells, as the child will eventually outgrow them.

References

  • Evans, Owen,B. Breath-Holding Spells. Pediatric Annals July 1997.
  • Anderson and Bluestone Breath Holding Spells Contemporary Pediatrics Jan, 2000
  • DiMario, Francis Prospective Study of Children with Cyanotic and Pallid Breath Holding Spells. Pediatrics February 2001

External links


'"/>


(Date:4/18/2014)... have made a discovery that turns 160 years of ... material long known to be essential for the fast ... is not as ubiquitous as thought, according to a ... Harvard Stem Cell Institute (HSCI) and the University,s Department ... Professor Jeff Lichtman, of Harvard,s Department of Molecular and ...
(Date:4/18/2014)... 2014) Benaroya Research Institute at Virginia Mason (BRI) ... particular molecule in metastatic breast cancer reduces both the ... metastases. BRI scientists have found in models of the ... 60 - 80 percent and can keep the tumor ... million five-year grant comes from the National Cancer Institute ...
(Date:4/18/2014)... French . ... medicine. A team led by Ludwik Leibler from the ... Didier Letourneur from the Laboratoire Recherche Vasculaire Translationnelle (INSERM/Universits ... the principle of adhesion by aqueous solutions of nanoparticles ... and tissues. This easy-to-use gluing method has been tested ...
(Date:4/17/2014)... signs of chronic inflammation in non-cancerous prostate tissue may ... cancer than those with no inflammation, according to results ... Johns Hopkins Kimmel Cancer Center. , The link between ... with so-called high-grade prostate cancer those with a ... presence of the most aggressive and rapidly growing prostate ...
(Date:4/17/2014)... Ill. One of the most popular vaccine brands ... And doctors may be overlooking some cost factors when ... a more expensive option, according to a new study ... vaccines to administer can be driven by numerous factors," ... and a professor of computer science and of mathematics ...
Breaking Medicine News(10 mins):Health News:Finding turns neuroanatomy on its head 2Health News:Finding turns neuroanatomy on its head 3Health News:Benaroya Research Institute evaluates immunology approach to blocking breast cancer 2Health News:Innovative strategy to facilitate organ repair 2Health News:Innovative strategy to facilitate organ repair 3Health News:Chronic inflammation linked to 'high-grade' prostate cancer 2Health News:Chronic inflammation linked to 'high-grade' prostate cancer 3Health News:Study recalculates costs of combination vaccines 2
... badly treated fractures are some of the reasons why ... often laid up, according to orthopaedic experts here. ... with many delicate and complicated surgeries being performed here ... at the All India Institute of Medical Sciences (AIIMS) ...
... eyes could reveal the status of our health and ... disease.// ,Conventional vision tests reveal eyesight abnormalities, such ... Rosen, of Rosen Eye Associates, Manchester, a test of ... heart disease, cancer and diabetes, thanks to its superior ...
... exposure to industrial chemicals is causing a ‘silent pandemic’ ... globe. ,This study was published on Tuesday ... 1-in-6 children and most of the cases are disorders ... that disorders like autism, attention deficit disorder, cerebral palsy ...
... advised to build a three-month stockpile of food, medicine and ... pandemic, a news report said Tuesday. ,An advisory ... in the former British colony urging them to prepare the ... ,It suggests stockpiling 4.5 litres of water per person per ...
... lower the risk of acquiring a sexually transmitted infection, ... ,The November issue of Pediatrics which reports ... of acquiring and spreading such infections by up to ... routine neonatal circumcision. ,This study is only ...
... getting heavier , but a new study by Statistics Canada has a ... pace as they did earlier. //Adults between 18-64 were monitored for ... showed that they have put on weight steadily , but during the ... ,This welcome news is thought to be due to the fact that ...
Cached Medicine News:Health News:Mismanagement of fractures a major concern, say experts 2Health News:Eye could reveal serious health disorder 2Health News:Brain disorders caused by Industrial chemicals 2Health News:Risk of STD Lowered with Circumcision 2
Other medicine definitionOther Tags