Related Experiment Videos
Breath holding spells: an analysis of 50 cases
M S Bhatia1, P K Singhal, N K Dhar
1Department of Pediatrics, Lady Hardinge Medical College, New Delhi.
Insights
Breath holding spells (BHS) in preschoolers are often linked to social behaviors and lower iron levels. Oral iron therapy significantly reduced the severity and frequency of these spells.
Area of Science:
- Pediatrics
- Child Neurology
- Hematology
Background:
- Breath holding spells (BHS) are common in preschool children, often occurring before 18 months of age.
- While triggers like anger are frequent, ante-, peri-, and postnatal factors show no significant association.
- Social behavior differences were noted between affected children and controls.
Purpose of the Study:
- To investigate the characteristics and potential contributing factors of breath holding spells in preschool children.
- To explore the association between BHS, behavioral patterns, and iron status.
- To evaluate the efficacy of oral iron therapy in managing BHS.
Main Methods:
- A study involving 50 preschool children diagnosed with BHS.
- Comparison with control groups using Behavior Screening Questionnaires and Attitude Screening Questionnaires.
- Assessment of hemoglobin and transferrin saturation levels.
- Intervention with oral iron therapy.
Main Results:
- BHS predominantly affected children under 18 months, with onset typically within the first year.
- Cyanosis and tonic-clonic spasms were observed in most cases, often triggered by frustration or anger.
- Significantly lower hemoglobin and transferrin saturation levels were found in children with BHS.
- Oral iron therapy led to a significant reduction in spell severity and frequency.
Conclusions:
- Breath holding spells in preschoolers may be associated with iron deficiency.
- Iron status and social behavior warrant consideration in the management of BHS.
- Oral iron supplementation appears to be an effective treatment for reducing BHS frequency and severity.
Abstract:
Of 50 preschool children having breath holding spells (M:F::3:1) (BHS), 80.0% were less than 18 months of age (mean age 16 +/- 5 mo). More children came from a lower social class (70.0%) and a nuclear family (64.0%). Seventy four per cent cases had onset of BHS within 12 months of age (mean 9.6 mo) and the commonest frequency was 1 to 3 spells per week (56.0%). Cyanosis and tonic-clonic spasms were seen in 96.0 and 84.0% cases, respectively. Anger and frustration were the common triggering factors in 90.0% cases. No ante-, peri- and postnatal factors were significantly associated with the study group as compared to the control cases. The mean scores on Behaviour Screening Questionnaire measuring child's habits related to feeding, toilet and sleep were not significantly different in the study and control groups but the difference was significant (p less than 0.05) for behaviour measuring child's social habits. Parental attitudes, measured on Attitude Screening Questionnaires, were also not significantly different in the study and control groups. Mean hemoglobin and percentage transferrin saturation were significantly lower in the study group as compared to the controls (p less than 0.001). There was a significant decrease in severity and frequency of spells with oral iron therapy.