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Prospective study of children with cyanotic and pallid breath-holding spells
1Department of Pediatrics, University of Connecticut, Connecticut Children's Medical Center, Hartford, Connecticut 06101, USA.
Insights
This study tracked children with severe breath-holding spells (BHS), finding they typically peak between 12-18 months and resolve by age 3-4 years. Hypoxic convulsions occurred in 15% of cases.
Area of Science:
- Pediatric Neurology
- Child Development
Background:
- Breath-holding spells (BHS) are common in children, presenting as either cyanotic or pallid episodes.
- Understanding the natural progression of severe BHS is crucial for accurate diagnosis and parental guidance.
Purpose of the Study:
- To prospectively document the natural history of severe breath-holding spells (BHS) in children.
- To gather data on BHS types, frequency, associated phenomena, and resolution patterns.
Main Methods:
- Prospective cohort study involving 95 children with BHS.
- Structured interviews conducted at initial consultation and yearly intervals.
- Data collected on spell type, frequency, sequelae, family history, and age of termination.
Main Results:
- Median onset of BHS was 6-12 months, with peak frequency at 12-18 months.
- Most BHS resolved by a median age of 37-42 months; some persisted until age 7.
- Hypoxic convulsions associated with BHS in <=15%; 34% had a positive family history.
Conclusions:
- This study provides new data on the natural history of severe BHS.
- Findings are vital for family counseling and developing intervention strategies.
- Establishes baseline data for evaluating future treatment efficacy.
Objective:
In this investigation, we sought to prospectively document the natural history of severe breath-holding spells (BHS) among children with both cyanotic and pallid BHS who were referred for neurologic consultation.
Design:
Prospective cohort study.
Methods:
A structured interview was undertaken at the time of initial consultation and at subsequent 1-year intervals regarding type of BHS, frequency of spells, associated phenomenon, sequelae, family history, and age at termination of spells.
Results:
A total of 95 children (48 boys, 47 girls) with BHS were identified and followed over a 9-year interval. There were no significant differences between genders. Median onset age was between 6 and 12 months old with 15% presenting younger than 6 months. A median frequency of spells was weekly with 30% experiencing 1 or more spells per day. The median age at peak frequency was between 12 and 18 months old with a range extending from 6 months to 4 years of age. Of the patients whose BHS had remitted for >12 months' time (n = 67), the last spell occurred at a median age of 37 to 42 months. Of those children whose BHS were still occurring, the oldest age at time of latest spell was at 7 years old. Hypoxic convulsions were associated with BHS in
Conclusions:
In this study, new data concerning the natural history of BHS have been determined. The information is important for family counseling and identifying intervention strategies, and serves as baseline data to evaluate the efficacy of future treatment approaches.