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Cardiac pacing in the management of severe pallid breath-holding attacks

Dyanne Wilson1, Philip Moore, A Kirsten Finucane

  • 1Greenlane Paediatric and Congenital Cardiac Services, Starship Childrens Hospital, Auckland, New Zealand. da.wilson@auckland.ac.nz

Journal of Paediatrics and Child Health
|April 9, 2005
PubMed

Insights

Pacemaker insertion effectively managed severe reflex anoxic seizures in an infant, completely stopping syncope and seizures. This intervention significantly improved the child's and family's quality of life.

Area of Science:

  • Pediatric Neurology
  • Cardiology
  • Autonomic Nervous System Disorders

Background:

  • Reflex anoxic seizures (RAS), also known as pallid breath-holding attacks, are typically managed with reassurance.
  • Severe or frequent episodes of syncope and seizure activity in RAS may necessitate intervention.

Observation:

  • A 19-month-old infant presented with a history of severe reflex anoxic seizures.
  • The infant underwent pacemaker insertion due to the severity and frequency of syncopal and seizure events.

Findings:

  • Pacemaker insertion resulted in the complete cessation of syncope and seizures in the infant.
  • The intervention led to a significant improvement in the patient's and family's quality of life.

Implications:

  • Pacemaker insertion is presented as a viable and effective treatment option for severe reflex anoxic seizures.
  • This case report and literature review support the consideration of pacemaker implantation for refractory RAS.
  • Further research into the long-term efficacy and safety of pacemakers for RAS is warranted.

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