Changes of Autonomic Nervous System Function in Patients With Breath-Holding Spells Treated With Iron

Abstract

To evaluate the autonomic nervous system of patients with breath-holding spells after iron treatment, we attempted to determine whether a dysregulation of the autonomic nervous system reflexes exists in children with severe cyanotic breathholding spells. An electrocardiogram for each subject was recorded for 24 hours in the subject's home and parasympathetic activity was investigated by the fast Fourier transform method. Hematologic data and clinical symptoms of all three patients treated with iron improved and attacks of severe breath-holding spells disappeared. After iron treatment was started, the heart rate variability increased during sleep. It appears that supplementation of iron is effective in improving the dysregulation of autonomic nervous system reflexes.

Autonomic nervous system functions in children with breath‐holding spells and effects of iron deficiency

“…It could be speculated that decreased oxygen carrying capacity due to iron deficiency may affect myocardial oxygenation, causing prolonged sinus recovery and longer sinus pauses. It was previously demonstrated that supplemental iron was effective in improving the dysregulation of autonomic nervous system reflexes 21.…”

Cyanotic breath‐holding spells in children respond to adenotonsillectomy for sleep‐disordered breathing

“…Even if arising earlier than its 24‐month mean age of onset, BH will still typically persist beyond 2 years of age. This was seen in our control group, despite several months of iron supplementation – a proposed treatment for BH events – by the control subjects’ neurologist (Orii et al. , 2002).…”

Recurrent Life Threatening Events in a Neonate

“…The pathophysiological mechanisms of BHS remain controversial. The presence of an underlying dysfunctional autonomic nervous system with cerebral anoxia or cerebral ischemia resulting from vagus mediated cardiac arrest may be responsible for the condition [3][4][5][6]. The maturation delay in myelination of the brainstem could be the cause of breath-holding spells in children [7].…”