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Breath-Holding Spell

Breath Holding Spell (context Dependent Category)


Presentation

  • Note, that the use of anti-epileptic medications will not address the symptoms of breath holding spells.[5] Breath holding spells occur when children hold their breath as they are crying excessively.[1] In pediatrics, it is a common presentation and is[aaemrsa.blogspot.com]
  • To the best our knowledge, this study presents the first data on QOL before and after PM implantation in this group of patients.[annalspc.com]
  • Abstract Pallid breath-holding (PBH) is a childhood condition that presents with recurrent syncope. Although typically benign, severe cases can lead to asystole and anoxic seizures.[pediatrics.aappublications.org]
  • Obstruction of airway by blood Obstruction of airway by food On examination - abdominal breathing On examination - adventitious sounds present On examination - chest expansion unequal On examination - chest PN hyperresonant On examination - chest PN[icd9data.com]
  • Consanguinity was present in 8.7% of the patients.[adc.bmj.com]
Sleep Apnea
  • In addition, mild sleep apnea (Ondine curse) and severe cyanotic breath-holding spells occurred.[ncbi.nlm.nih.gov]
  • Cyanotic breath-holding spells may respond to treatment with iron supplements, even when the child does not have iron-deficiency anemia, and to treatment for obstructive sleep apnea (if the child has it).[msdmanuals.com]
  • Breath-holding spells need to be distinguished from epilepsy, typical fainting episodes (medically called syncope), from gastrointestinal acid reflux in babies, sleep apnea, cardiac heartbeat irregularities (arrhythmias) and temper tantrums.[epilepsy.com]
Choking
  • Choking – while choking can be a life-threatening emergency, most episodes of choking aren’t.[keepkidshealthy.com]
  • What to do during a breath-holding spell Keep your child safe by rolling her onto her side and checking her mouth for food or objects she could choke on.[allparenting.com]
  • Also, don't put anything in your child's mouth because it could make him choke or vomit. Treatment after attacks of breath-holding Give your child a brief hug and go about your business. A relaxed attitude is best.[kpjampang.com]
  • If your child passes out for a brief time, stay calm and: check your child's mouth for food or any object that could pose a choking hazard once your child regains consciousness remove all objects or furniture within reach in case your child has a seizure[kidshealth.org]
  • Instead, if you are certain she hasn’t choked on something, place her in a safe spot (without giving in to whatever she held her breath to achieve), and ignore her behavior.[drgreene.com]
Behavior Problem
  • Although the child is not having the breath-holding spells due to a behavior problem, the child can develop a behavior problem if the family starts to alter their customary discipline to try to keep the child from becoming upset and having breath-holding[childneurologyfoundation.org]
  • This can lead to behavior problems that may last even after she’s outgrown her breath-holding spells.[webmd.com]
  • In fact, children will grow out of behavioral problems such as BHS as they learn to express themselves in more sophisticated ways.[abcnews.go.com]
  • Because they're involuntary (not done on purpose), they're not a behavioral problem. A doctor can help parents understand what triggers a spell in their child, how to prevent future spells, and how to deal with them if they do happen.[kidshealth.org]
Aphasia
  • Piracetam as an adjuvant to language therapy for aphasia: A randomized double-blind placebo-controlled pilot study. Archives of Physical and Medical Rehabilitation 1997 ; 78: 245 – 250 Google Scholar Crossref Medline ISI 23.[doi.org]
Unstable Gait
  • She was admitted to our hospital because of delayed and unstable gait. Since magnetic resonance imaging showed a cervicomedullary tumor, she underwent a radical resection and histology showed the tumor to be a ganglioglioma.[ncbi.nlm.nih.gov]

Workup

Sinus Arrhythmia
  • Respiratory sinus arrhythmia in children with severe cyanotic and pallid breath-holding spells. J Child Neurol 1998;13:440-2 10. DiMario FJ Jr, Chee CM, Berman PH. Pallid breath-holding spells. Evaluation of the autonomic nervous system.[annalspc.com]

Treatment

  • Piracetam is an effective prophylactic treatment for severe BHS.[ncbi.nlm.nih.gov]
  • It is suggested that piracetam is a safe and effective drug, with an incidence of side effects no different from that of placebo, for the treatment of breath-holding spells.[ncbi.nlm.nih.gov]
  • […] is effective in the treatment of BHS and that iron deficient children are more likely to benefit from such treatment. 8 Our data suggest that iron may be crucial in the treatment of BHS because IDA may be the main underlying defect.[adc.bmj.com]
  • Breath-holding spells is a relatively common disorder in young children that usually spontaneously resolves and needs no treatment.[circ.ahajournals.org]
  • Clinical efficacy of piracetam in treatment of breath holding spells. Pediatric Neurology 1998 ; 18: 41 – 45 Google Scholar Crossref Medline ISI 7. DiMario, FJ. Breath-holding spells in childhood.[doi.org]

Prognosis

  • Outlook (Prognosis) Most children outgrow breath holding spells by the time they are 4 – 8 years old. Children who have a seizure during a breath holding spell are not at more risk of getting a seizure disorder.[coordinatedhealth.com]
  • Outlook (Prognosis) Most children outgrow breath holding spells by the time they are 4 to 8 years old. Children who have a seizure during a breath holding spell are not at more risk of getting a seizure disorder.[nicklauschildrens.org]
  • Outlook (Prognosis) Most children outgrow breath holding spells by the time they are 4 to 8 years old. Children who have a seizure during a breath holding spell are not at higher risk of having seizures otherwise.[m.ufhealth.org]
  • See also: Temper tantrums Support Groups Expectations (prognosis) Most children outgrow breath holding spells by ages 4 - 8.[mostellarmedical.org]

Etiology

  • The book is designed to supplement standard textbooks that provide detailed information on etiology, pathogenesis and therapeutic controversies in pediatric clinical neuroscience.[books.google.com]
  • Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'.[icd10data.com]

Epidemiology

  • 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.[ncbi.nlm.nih.gov]
  • 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. ( AJDC. 1992;146:125-131)[doi.org]
  • View some real examples: Example 1 Example 2 Example 3 Great Video for a quick explanation of BHS: Epidemiology Occurs in approximately 5% of the population with equal distribution between males and females.[pedclerk.bsd.uchicago.edu]
Sex distribution
Age distribution

Pathophysiology

  • Prior research concerning the underlying pathophysiologic mechanisms involved in breath-holding spells has implicated an autonomic nervous system dysregulation.[ncbi.nlm.nih.gov]
  • Anaemia may have played a role in the pathophysiology leading to life-threatening events in some of the infants investigated in this study.[ncbi.nlm.nih.gov]
  • These events are unique to childhood, though they may have the same pathophysiology as similar events that occur in adults. It is important to understand that these episodes are not temper tantrums.[journals.lww.com]
  • The estimated prevalence of these severe BHS is about 0.6-4%. [2] Although the exact pathophysiology remains unknown, most authors differentiate between two basic mechanisms resulting in either pallid (pBHS) or cyanotic (cBHS) BHS.[annalspc.com]

Prevention

  • What can I do to help prevent breath-holding spells? Most attacks from falling down or a sudden fright can't be prevented. Neither can most attacks that are triggered by anger.[kpjampang.com]
  • Often, the spells can be predicted and even prevented from occurring once the factors that trigger them have been identified.[news-medical.net]
  • Preventing breath-holding You can’t prevent breath-holding, but you might be able to prevent the events leading up to it: Before children start to get upset, try to distract them. Reassure children after they’ve had a fright or a shock.[raisingchildren.net.au]
  • Preventing Future Spells Once kids mature and develop better coping skills, they usually outgrow breath-holding spells.[kidshealth.org]
  • Distracting children and avoiding situations that lead to tantrums are the best ways of preventing and treating these spells.[msdmanuals.com]

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