Persistence of Breath-Holding Spells Into Late Childhood

Goraya, Jatinder S.; Virdi, Verinderjit S.

doi:10.1177/088307380101600916

Cited by 17 publications

(14 citation statements)

References 6 publications

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“…We believe that in children with breath-holding spells, these control mechanisms are likely immature and hence easily dysregulated by triggers resulting in prolonged expiratory apnea and inhibition of inspiration. 11 Inability to breathe in (mislabeled as breath-holding) experienced by our child and also previously reported 13 at the onset of spell indicates the failure of the inspiration-expiration switch of the central respiratory control mechanisms in the genesis of cyanotic breathholding spells. Theophylline through its various positive respirogenic effects is able to set the central respiratory neural drive in an ''overdrive'' mode, rendering it resistant to dysregulation by triggers.…”

Section: Discussionsupporting

confidence: 68%

Treatment of Cyanotic Breath-Holding Spells With Oral Theophylline in a 10-Year-Old Boy

Garg

Goraya

2014

J Child Neurol

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Cyanotic breath-holding spells are generally benign and resolve spontaneously by 4 to 5 years of age. Treatment with iron and other drugs has been employed in selected cases with very frequent and severe episodes. We describe a 10-year-old boy with recent-onset cyanotic breath-holding spells that were activity limiting. He was unable to participate in physical activities with his peers as any argument or emotional upset provoked these spells. Treatment with oral iron and piracetam was ineffective. However, treatment with oral theophylline produced dramatic amelioration of symptoms, and he was once again able to participate in play activities with his peers. We believe that general central nervous system stimulant and respirogenic effects of theophylline were instrumental in control of symptoms in our child.

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Section: Discussionsupporting

confidence: 68%

Treatment of Cyanotic Breath-Holding Spells With Oral Theophylline in a 10-Year-Old Boy

Garg

Goraya

2014

J Child Neurol

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“…Breath holding spells were observed more frequently in boys than in girls. In our study the ratios were found to be 1.1: 1, 3: 1, 1.7:1 and 1.3: 1 in Ashrafi et al, 15 Lombroso et al, 5 Diamario et al 8 and Goraya et al 16 studies respectively. In a group of 384 children (3 months to 4 years) studied by Livingston, the mean age at onset of Breath holding spell was 12 months.…”

Section: Resultssupporting

confidence: 54%

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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“…In Ashrafi et al’s study ( 7 ), anger and pain were the common triggering factors (65.1%). Other studies reported that BHS was provoked by frustration, anger, fear, or pain, i.e., Goraya et al ( 17 ), Daoud et al ( 18 ), and Evans Owen ( 19 ). Consanguinity was present in 53.13% of patients, and these results were much higher than those of Ashrafi et al’s study ( 7 ) (30%) or Hilal Mocan et al’s study ( 20 ) (8.7%).…”

Section: Discussionmentioning

confidence: 99%

Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt

Sadek¹,

Mohamed²,

Sharaf³

et al. 2016

Electron physician

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IntroductionBreath-holding spells (BHSs) are involuntary pauses of breathing, sometimes accompanied by loss of consciousness. They usually occur in response to an upsetting or surprising situation. Breath-holding spells are usually caused by either a change in the usual breathing pattern or a slowing of the heart rate. In some children, BHSs may be related to iron deficiency anemia. The aim of the work was to study the clinical and laboratory profile of BPHs in children presented to the Neuropediatric Clinic at Sohag University Hospital.MethodsAn observational prospective study was done at Sohag University Hospital over a period of one year on children diagnosed as having BHSs by clinical history and laboratory evaluation, including complete blood count (CBC), serum iron, serum ferritin, total iron binding capacity, and Electroencephalography (EEG).ResultsDuring the period of study (one year), we reviewed data of 32 children who had been diagnosed as having BHSs. We found that cyanotic spells (71.88%) predominated over pallid spells. There were positive family histories (31.25%) and consanguinity (53.135) in the studied patients. We found a high incidence of iron deficiency anemia (62.5%) in association with BHS. Abnormal EEGs were found in (65.63%) of studied children.ConclusionBHS is a common, important problem associated with iron deficiency anemia, which is, in turn, a common nutritional problem in our country.

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Persistence of Breath-Holding Spells Into Late Childhood

Cited by 17 publications

References 6 publications

Treatment of Cyanotic Breath-Holding Spells With Oral Theophylline in a 10-Year-Old Boy

Treatment of Cyanotic Breath-Holding Spells With Oral Theophylline in a 10-Year-Old Boy

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

Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt

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