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Breath-holding spells

G N Breningstall1

  • 1Department of Pediatrics (Neurology), Park Nicollet Medical Center; Minneapolis, MN 55404, USA.

Pediatric Neurology
|February 1, 1996
PubMed
Summary
This summary is machine-generated.

Breath-holding spells, common in children, include pallid (vagal) and cyanotic (complex) types. Diagnosis relies on history, with ECG and EEG aiding pallid spell evaluation, and spontaneous resolution is expected.

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Area of Science:

  • Pediatrics
  • Neurology
  • Cardiology

Background:

  • Breath-holding spells are common, frightening episodes in early childhood, presenting as syncope or anoxic seizures.
  • Two primary types exist: pallid breath-holding spells and cyanotic breath-holding spells, each with distinct underlying mechanisms.

Observation:

  • Pallid spells stem from vagally-mediated cardiac inhibition.
  • Cyanotic spells involve complex interactions of hyperventilation, Valsalva maneuver, expiratory apnea, and pulmonary factors.

Findings:

  • Diagnosis is primarily based on patient history, with videotape documentation being a potential aid.
  • Electrocardiogram (ECG) for prolonged QT syndrome and electroencephalogram (EEG) with ocular compression for pallid spells are recommended investigations.

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Implications:

  • Spontaneous resolution of breath-holding spells without long-term sequelae is anticipated.
  • Therapy primarily involves reassurance, with occasional pharmacologic interventions considered beneficial.