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Breath-holding spells in childhood
1Department of Pediatrics, University of Connecticut Health Center, Farmington 06030.
Insights
Childhood breath-holding spells, common in healthy children, involve autonomic nervous system dysregulation. These episodes can lead to temporary cerebral anoxia and loss of consciousness.
Area of Science:
- Pediatrics
- Neurology
- Autonomic Nervous System
Background:
- Breath-holding spells are a common pediatric phenomenon.
- They manifest in cyanotic and pallid forms.
- These spells have been historically documented for centuries.
Purpose of the Study:
- To summarize clinical and epidemiologic aspects of breath-holding spells.
- To delineate underlying respiratory and neural physiologic interactions.
- To outline practical treatment approaches.
Main Methods:
- Literature review and synthesis of existing research.
- Analysis of clinical presentations and epidemiological data.
- Delineation of physiological mechanisms.
Main Results:
- Identified two primary clinical forms: cyanotic and pallid.
- Implicated autonomic nervous system dysregulation in pathogenesis.
- Cerebral anoxia identified as the cause of unconsciousness in severe spells.
Conclusions:
- Breath-holding spells are linked to autonomic nervous system dysfunction.
- Understanding the pathophysiology aids in management.
- Practical treatment strategies can be derived from physiological insights.
Abstract:
Childhood breath-holding spells are a common and frightening phenomenon occurring in healthy, otherwise normal children. They have been well recognized for several hundred years. There appear to be two clinical forms: the cyanotic type and the pallid type, referring to the color change exhibited by the child during the episode. Prior research concerning the underlying pathophysiologic mechanisms involved in breath-holding spells has implicated an autonomic nervous system dysregulation. Cerebral anoxia is the ultimate factor responsible for the loss of consciousness observed in the severe forms of breath-holding spells. The clinical and epidemiologic aspects of breath-holding spells are herein summarized. The pertinent respiratory and neural physiologic interactions involved are delineated, as well as practical treatment approaches.