Breath-holding spells

Breningstall, Galen N.

doi:10.1016/0887-8994(96)00006-9

Cited by 100 publications

(71 citation statements)

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“…Unexpected death has been reported in children with BHS, although other causes of death were entertained in some cases (10,11). In 1990, Southall et al (12) reported sudden death in eight of 51 infants and young children with recurrent episodes of cyanosis and loss of consciousness precipitated by crying.…”

Section: Figure 1) a Rhythm Strip From An Event Recorder At The Time mentioning

confidence: 99%

A pacemaker for asystole in breath-holding spells

Legge

Kantoch

Seshia

et al. 2002

Paediatrics &Amp; Child Health

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Two cases of young children with frequent severe breath-holding spells complicated by prolonged asystole and seizures are reported. A ventricular pacemaker was implanted in each child, and both have subsequently remained free of syncope, although they continue to exhibit breath-holding behaviour.Key Words: Asystole; Breath-holding; Pacemaker; Syncope Un stimulateur en cas d'asystolie dans les spasmes du sanglotOn rend compte du cas de deux jeunes enfants présentant des spasmes du sanglot fréquents et graves, compliqués par une asystolie prolongée et des convulsions. Un stimulateur ventriculaire a été implanté chez chaque enfant, et si tous deux ont continué à faire des spasmes du sanglot, ils n'ont plus fait de syncopes. B reath-holding spells (BHS) are common in early childhood, typically occurring between the ages of six months and four years. Severe pallid spells and, less commonly, cyanotic spells may be complicated by the loss of consciousness, posturing and generalized seizures. A toddler and an infant who experienced prolonged asystole at the time of severe BHS and who were treated with the implantation of ventricular pacemakers are described. CASE 1 PRESENTATIONAn 18-month-old "determined and busy" girl was referred to the cardiology clinic with a history of syncope since the age of 11 months. All events were precipitated by the child being upset, usually when something was taken away from her without warning or when she experienced a minor injury. The child would cry hard; become cyanotic; stop breathing on expiration; turn silent, pale and limp; and lose consciousness. She would recover with an inspiratory gasp within a few minutes. The parents documented 49 BHS. On four occasions, the child developed opisthotonic posturing and myoclonic jerks. Twice the pupils became dilated and she became incontinent. Her tone and skin colour improved gradually over several minutes. Spells were followed by at least one-and-a-half hours of sleep. When the parents learned about asystole associated with breath-holding, they treated the individual episodes with oxygen, res-

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Section: Figure 1) a Rhythm Strip From An Event Recorder At The Time mentioning

confidence: 99%

A pacemaker for asystole in breath-holding spells

Legge

Kantoch

Seshia

et al. 2002

Paediatrics &Amp; Child Health

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“…Indeed, in some children Breath holding spells may be the precipitation of epileptic seizure or status epilepticus enhancing the confusion. 9 The striking association of anaemia with Breath holding spells was first reported in 1963 by Halowach and Thurston. 10 It was hypothesised that the low haemoglobin causes rapid cerebral anoxia due to decreased oxygen carrying capacity of blood that in turn leads to the Breath holding spells.…”

Section: Resultsmentioning

confidence: 99%

Clinical and Epidemiological Profile of Breath Holding Spells (Bhs)- An Analysis of 115 Cases

Bhavanishankar¹,

Ramu²,

N³

2018

jemds

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BACKGROUND Breath holding spells are common in non-epileptic, repetitive, paroxysmal events in young infants and children often considered as seizure mimics/ confused with seizure disorder can be a frightening experience for parents and demands a good history of the sequence of events, because the diagnosis is made clinically. Aims and Objectives-To study the disease spectrum of Breath holding spells in infants and children in terms of clinical and epidemiological profile (i.e. age, sex, family history, parental consanguinity, triggering factors, associated comorbidities such as anaemia etc.). MATERIALS AND METHODSThis case series study was conducted in our Child health clinics. A total of 125 children below 6 years with Breath holding spells were enrolled between May 2012 and April 2017, out of which 10 children were excluded from the study due to various causes. Remaining 115 children diagnosed as Breath holding spells by typical history, clinical examination and after ruling out other causes which mimic Breath holding spells are included in the study. RESULTSIn the present study, a total of 115 children aged between 6 months and below 6 years were diagnosed as having Breath holding spells. In 73 (63.41%) cases Breath holding spells began during the first 24 months of age. Most common triggering factor bei ng anger (45.2%) and pain (41.7%). A positive family history was found in 27% and parental consanguinity was found in 30.43% of cases. The spells were cyanotic in 62.6% and 76.52% were anaemic. CONCLUSIONThe result of this study suggests a new data regarding the natural history of Breath holding spells and is important for identifying interventional strategies and parental counselling and could serve as baseline data for future approaches on this paediatric clinical entity. KEYWORDSBreath Holding Spells, Cyanotic, Pallid, Anaemia. HOW TO CITE THIS ARTICLE: Bhavanishankar R, Ramu P, Chaitanya N. Clinical and epidemiological profile of breath holding spells (BHS)-an analysis of 115 cases. J. Evolution Med. Dent. Sci. 2018;7(04):534-539, DOI: 10.14260/jemds/2018/119 BACKGROUND Breath holding spells are common in non-epileptic, repetitive, reflexive events described under "behavioural disorders" of children and are initiated by provocative events that cause anger, frustration or pain causing the child to cry. The term Breath holding spells is actually a misnomer, as these are not self-induced but results from immaturity of autonomic system and occurs in two different forms. The first type is pallid Breath holding spells. The second type is the cyanotic or blue Breath holding spells. Episodes usually start with a cry (often in the case of pallid type, a silent cry with marked pallor) and progress to apnoea and cyanosis. Some authors have described third variety as mixed Breath holding spells,

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“…Os últimos fatores são lentos demais para explicar o rápido estabelecimento da cianose. Uma possível explicação seria a combinação imperfeita da ventilação e da perfusão, que resulta em desvio (shunt) intrapulmonar da direita para a esquerda 33 .…”

Section: Síncope Cardioinibidora Ou Pálidaunclassified

Distúrbios paroxísticos não-epilépticos

Menezes

2002

J. Pediatr. (Rio J.)

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ResumoObjetivo: este artigo tem como objetivo discutir um dos principais problemas com os quais um pediatra geral tem que lidar no campo da neurologia infantil, que são os distúrbios paroxísticos não-epilépticos. Estes episódios também são uma causa freqüente de consultas aos neuropediatras e de internação em unidades de monitorização por vídeo-eletrencefalograma.Fontes dos dados: revisão da literatura sobre o assunto na Medline. Vários compêndios de neurologia pediátrica também foram usados, por conterem informações importantes sobre o assunto.Síntese dos dados: muitas das entidades discutidas neste artigo são freqüentes na população pediátrica, como, por exemplo, a síncope, as crises de perda do choro, e os movimentos patológicos associados ao refluxo gastroesofágico. Outras entidades são mais raras, como as distonias paroxísticas e a distonia com flutuação diurna.Conclusões: o conhecimento básico das várias síndromes associadas com distúrbios paroxísticos não-epilépticos é extremamente importante para o pediatra geral, porque pode evitar exames desnecessários e o diagnóstico errôneo de epilepsia, expondo as crianças às medicações que não vão melhorar o quadro clínico, e que podem causar efeitos colaterais.J Pediatr (Rio J) 2002; 78 (Supl.1): S73-S88: epilepsia, convulsão, distúrbios paroxísticos não-epilépticos, síncope, distúrbios do movimento, tetania, hiperecplexia, vertigem. AbstractObjective: this article aims at reviewing one of the most important problems faced by pediatricians in the field of child neurology. The paroxystic non-epileptic events are also a frequent reason for pediatric neurology consultations and admission for diagnostic videoelectroencephalogram monitoring.Sources: literature review on the subject was perform on Medline, data were also collected from the main Pediatric Neurology Textbooks, which were found to be an important and unique source of information on the subject.

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Breath-holding spells

Cited by 100 publications

References 29 publications

A pacemaker for asystole in breath-holding spells

A pacemaker for asystole in breath-holding spells

Clinical and Epidemiological Profile of Breath Holding Spells (Bhs)- An Analysis of 115 Cases

Distúrbios paroxísticos não-epilépticos

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