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Breath holding spells: evaluation of autonomic nervous system function

B G Anil1, K Nedunchezian, V Jayanthini

  • 1Department of Pediatrics, Institute of Child Health and Hospital for Children, Chennai, Tamilnadu, India. dranilbg@yahoo.com

Indian Pediatrics
|October 7, 2005
PubMed

Insights

Children with breath holding spells (BHS) show signs of autonomic nervous system (ANS) dysfunction. These autonomic reflex abnormalities suggest a generalized underlying condition in children experiencing BHS.

Area of Science:

  • Pediatric Neurology
  • Autonomic Nervous System Function

Background:

  • Breath holding spells (BHS) are common in children.
  • The underlying pathophysiology of BHS is not fully understood.
  • Autonomic nervous system (ANS) dysfunction has been hypothesized as a potential contributor.

Purpose of the Study:

  • To noninvasively assess for autonomic reflex dysregulation in children with a history of BHS.
  • To compare ANS function in children with BHS to a control group of healthy children.

Main Methods:

  • Evaluated 50 children (13-47 months) with BHS and 100 age/sex-matched controls.
  • Assessed autonomic function through heart rate, blood pressure, 30:15 RR ratio, pupillary response to pilocarpine, and orthostatic signs.

Main Results:

  • Children with BHS exhibited significantly higher resting heart rate and abnormal resting diastolic blood pressure.
  • Abnormal 30:15 RR ratio, hypersensitive pupillary response, and positive orthostatic signs were observed in the BHS group compared to controls.

Conclusions:

  • Findings suggest a subtle, generalized autonomic dysfunction in children with breath holding spells.
  • This autonomic dysregulation may play a role in the pathophysiology of BHS.

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