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:9/4/2015)... Monroe, NC (PRWEB) , ... September 04, 2015 ... ... Girl’s Night out to benefit Core Compassion Project. Core Compassion Project is ... a specialized program to reduce the side effects of cancer treatments and recover ...
(Date:9/4/2015)... ... 04, 2015 , ... “Getting away from the daily stressors and distractions of ... strengthen their ‘couple-ness,’” says Jean Claude Wietzel, general manager at Four Seasons Resort ... island’s only Forbes Five Star resort and Travel + Leisure’s No. 1 Hotel in ...
(Date:9/4/2015)... ... September 04, 2015 , ... The USC Eye Institute is proud to announce ... Doximity. Faculty, residents and staff are honored to have contributed to the success ... our ophthalmology residency program. Our faculty places a high priority on our educational programs ...
(Date:9/4/2015)... ... September 04, 2015 , ... Lalonde Gordon ran a ... followed up with victory in the men’s 400 meters final, with an impressive 44.89 ... Field Championships in San Jose, Costa Rica in August 2015. The 44.64 time is ...
(Date:9/4/2015)... ... 2015 , ... FiltersFast.com, the online retail leader in air ... up. FiltersFast.com, will ship all orders over $50.00 for free. Use this ... advantage of this promotion now through September 8, 2015. , Filtersfast.com offers a ...
Breaking Medicine News(10 mins):Health News:Girl’s Night Out to Benefit Core Compassion Project, Located at the Beautiful, Morning Glory Farm 2Health News:Couples Season at Four Seasons Resort Maui Begins This Week With Best Hotel Rates of the Year through November 2Health News:Couples Season at Four Seasons Resort Maui Begins This Week With Best Hotel Rates of the Year through November 3Health News:USC Ophthalmology Residency Program Ranked in Top 10 by Doximity 2Health News:USC Ophthalmology Residency Program Ranked in Top 10 by Doximity 3Health News:Lalonde Gordon’s Recipe Brings Home the Gold 2Health News:Lalonde Gordon’s Recipe Brings Home the Gold 3Health News:FiltersFast.com Wows with a Long Labor Day Weekend Shipping Offer 2
... The Massachusetts Eye and Ear Infirmary Cataract Surgery Trainer, ... to perform cataract surgery, has been shown to enhance ... methods. The results of a multi-center study evaluating the ... was published in the February issue of Ophthalmology ...
... name) was born in Bangladesh yet raised in Montreal. At 16, ... of visiting her sick grandmother. The young woman was then forced ... The girl later wrote to her mother that she was ... After two months, her mother granted her return to Montreal. By ...
... certain cancer surgeries can have the procedures performed with ... a new study. The research showed that for ... and colon, younger patients with few pre-existing illnesses survived ... at cancer centers. But patients who are considered ...
... ... , ... San Diego, CA (PRWEB) January 22, 2010 -- Professional athletes, everyday athletes and ... Muscle Stimulation (NMES). Electrostimulation therapy isn’t new technology – it’s been widely used ...
... Hispanic moms spend more time in front of the ... -- Young children of Hispanic mothers whose main language ... moms who speak mostly English, a U.S. study has ... Hispanic and white mothers with children aged 4 months ...
... over possible link between MMR vaccine, developmental disorder ... British medical journal The Lancet on Tuesday ... the measles, mumps and rubella vaccine to autism and ... Feb. 28, 1998, set off a worldwide furor, with ...
Cached Medicine News:Health News:Mass. Eye and Ear Infirmary Cataract Surgery Trainer teaches residents cataract surgery 2Health News:Mass. Eye and Ear Infirmary Cataract Surgery Trainer teaches residents cataract surgery 3Health News:From Quebec to France: forced marriages still exist 2Health News:Community hospitals offer a safe surgical option for some cancer surgeries 2Health News:Electrical Muscle Stimulation Proven to Enhance Muscle Development and Sports Performance 2Health News:Electrical Muscle Stimulation Proven to Enhance Muscle Development and Sports Performance 3Health News:Electrical Muscle Stimulation Proven to Enhance Muscle Development and Sports Performance 4Health News:Spanish-Speaking Mothers Less Likely to Turn on TV 2Health News:Flawed Autism Study Retracted by Medical Journal 2Health News:Flawed Autism Study Retracted by Medical Journal 3
Other medicine definitionOther Tags