Breath-Holding Spells and Anemia

Holowach, Jean; Thurston, Don L.

doi:10.1056/nejm196301032680105

Cited by 58 publications

(27 citation statements)

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“…Holowach et al demonstrated that children with severe BHS had significantly lower haemoglobin values than children in a control group 3. Bhatia et al also found that children with BHS had significantly lower haemoglobin and serum iron values, a lower percentage of transferrin saturation, and higher TIBC than those of controls 6…”

Section: Discussionmentioning

confidence: 99%

Breath holding spells in 91 children and response to treatment with iron

Mocan

Yıldıran

Orhan

et al. 1999

Archives of Disease in Childhood

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To evaluate the prognosis of breath holding spells (BHS) after iron treatment, 91 children (56 boys, 35 girls) aged between 6 months and 40 months (median, 17) were followed prospectively for a median of 45 months (range, 6-89). In 49 of the children, the frequency of BHS was less than 10 each month, in 22 it was 10-30 each month, and in 20 more than 30 each month. The spells were cyanotic in 60 children. All patients were evaluated initially and during follow up for haematological indices. Electroencephalographic and electrocardiographic abnormalities were also recorded. Sixty three patients were found to have iron deficiency anaemia and were treated with iron (6 mg/kg/ day) for three months. Other patients were not given any treatment. After three months, there was a significant diVerence for correction of cyanotic spells between children who had been treated with iron and those who had not (84.1% v 21.4%). During further follow up, febrile convulsions occurred in 10 children (six were on iron treatment initially). It appears that treating iron deficiency anaemia is eVective in reducing the frequency of BHS. (Arch Dis Child 1999;81:261-262)

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Section: Discussionmentioning

confidence: 99%

Breath holding spells in 91 children and response to treatment with iron

Mocan

Yıldıran

Orhan

et al. 1999

Archives of Disease in Childhood

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“…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. It was also thought that the anaemic children being irritable may be more predisposed to 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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“…Holowach et al demonstrated that children with severe BHS had significantly lower haemoglobin values than children in a control group. They speculated that children with anemia have decreased cerebral oxygen tension at baseline making these children more susceptible to the chain of events leading to loss of consciousness during BHS [41]. Bhatia et al also observed that children with BHS had significantly lower haemoglobin and serum iron values, a lower percentage of transferrin saturation, and higher TIBC than those of controls [42].…”

Section: Ida and Breath Holding Spellsmentioning

confidence: 99%

Iron Deficiency: Beyond Anemia

Yadav

Chandra

2010

Indian J Pediatr

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Iron deficiency is the most common nutritional disorder affecting at least one third of world's population. Though anemia is common manifestation of iron deficiency, other effects of iron deficiency on various tissues, organs and systems are usually under recognized. Impaired brain development and cognitive, behavioural and psychomotor impairment are most worrisome manifestations of iron deficiency. Studies have demonstrated that some of these changes occurring during period of brain growth spurt (<2 years age) may be irreversible. Association of iron deficiency with febrile seizures, pica, breath holding spells, restless leg syndrome and thrombosis is increasingly being recognized. Impaired cell-mediated immunity and bactericidal function are generally noted in iron-deficient persons; however, the findings are inconsistent. Despite proven reversible functional immunological defects in vitro studies, a clinically important relationship between states of iron deficiency and susceptibility to infections remains controversial. Studies from malaria endemic regions have reported increased incidence of malaria in association with iron supplementation. These and some other aspects of iron deficiency are reviewed in this article.

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Breath-Holding Spells and Anemia

Cited by 58 publications

References 3 publications

Breath holding spells in 91 children and response to treatment with iron

Breath holding spells in 91 children and response to treatment with iron

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

Iron Deficiency: Beyond Anemia

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