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Breath-Holding Spell
Breath Holding Spell (context Dependent Category)

Presentation

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]

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]

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]

Cyanotic breath-holding has been found to respond to iron therapy (1), even in the absence of anemia, and to treatment for obstructive sleep apnea (when present). During a pallid breath-holding spell, vagal stimulation severely slows the heart rate. [merckmanuals.com]

Entire Body System

  • Anemia

    Both patients had signs, symptoms, and laboratory findings of severe anemia. With correction of anemia the breath-holding spells promptly and completely resolved in each case. [ncbi.nlm.nih.gov]

    In a study of 165 children with breath holding spells, 47.9% of children were found to have iron deficiency anemia.[4] Iron deficiency anemia is not the reason for breath holding spells and it is unclear the correlation. [aaemrsa.blogspot.com]

    Some trials have demonstrated the efficacy of iron therapy, especially because although BHS can readily occur without anemia, BHS has been found to be exaggerated by the presence of anemia. [en.wikipedia.org]

    Sometimes, iron deficiency anemia might cause kids to have breath-holding spells. So a doctor might do a blood test to check for anemia. Treating the anemia may help reduce the number of the spells. [kidshealth.org]

    Anemia, or a low blood count, may cause a child who has breath-holding spells to have more frequent episodes, but anemia is not the cause for the episodes. Most children with breath-holding spells are otherwise healthy. [childneurologyfoundation.org]

Gastrointestinal

  • Choking

    Choking – while choking can be a life-threatening emergency, most episodes of choking aren’t. [keepkidshealthy.com]

    Was she choking?! I flipped her over and hit her several times with my palm in between her shoulder blades (thank goodness I had remembered what to do in case a baby was choking). But still nothing. She was even more blue. [modernlymorgan.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]

  • Vomiting

    No Limits on Getting Attention Other attention-seeking behaviors children may exhibit can include banging their head against a wall or vomiting on command. But breath holding is a real eye opener, for parents and doctors. [abcnews.go.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]

    And since hives are very itchy, that child is probably going to be miserable, which can make hives very scary, even though without other symptoms (like vomiting or trouble breathing), they typically aren’t a sign of a serious allergic reaction. [keepkidshealthy.com]

    If the child has a breath-holding spell and goes limp, turn the child on his or her side to prevent choking on spit or vomit. If the child was eating when the breath-holding spell occurred, be sure the mouth is free of food. [fairview.org]

    A child may vomit or urinate during a seizure. When to call the doctor Breath holding spells may have symptoms in common with various seizure disorders or other medical conditions. [healthofchildren.com]

Neurologic

  • Screaming

    "His mouth was wide open like the wires got crossed and he didn't start screaming because his mouth was open and stuck," she said. [abcnews.go.com]

    The child may then gasp and start crying or screaming. Or, he or she may even lose consciousness and start breathing again. Some healthcare professionals view breath-holding spells as a way to communicate anger. [mhealth.org]

    Typically, the child cries or screams and then stops breathing. The skin then begins to turn blue, particularly around the lips, which is caused by a shortage of oxygen. The child then becomes unconscious. [news-medical.net]

    Some attacks result from hyperactive normal reflexes, such as slowing of the heart rate when the eyes are rubbed, or when the child tries to breathe or scream against a closed throat (the Valsalva response). [epilepsy.com]

    Night terrors – often confused for nightmares, a child having a night terror will wake up in the early part of the night yelling and screaming, which is why parents think their child is having a nightmare. [keepkidshealthy.com]

  • Confusion

    Night terrors – often confused for nightmares, a child having a night terror will wake up in the early part of the night yelling and screaming, which is why parents think their child is having a nightmare. [keepkidshealthy.com]

    As breath-holding spells may look like epileptic seizures, the 2 are often confused. Breath-holding spells happen after your child has been frustrated, startled or hurt. [kidshealth.org.nz]

    Afterwards the child will regain consciousness, but may appear sleepy and confused for a few hours. [nhs.uk]

    Clinically, these patients demonstrate a prolonged QT period on electrocardiogram, which may be associated with cyanosis and pallor.[3] Breath holding spells may be confused with a Brief Resolved Unexplained Event; however, they have benign consequences [aaemrsa.blogspot.com]

    They may be confused with a seizure disorder. They are sometimes observed in response to frustration during disciplinary conflict. There are four types of breath-holding spells. [en.wikipedia.org]

  • Convulsions

    Louis Children's Hospital from 1934 to 1961 (51) and all registered in the convulsive outpatient clinic from 1951 to 1961. .. Funding and Disclosures * From the Department of Pediatrics, Washington University School of Medicine, and the St. [nejm.org]

    During further follow up, febrile convulsions occurred in 10 children (six were on iron treatment initially). [adc.bmj.com]

    Even after he stopped convulsing, he was not acting normal. Brad said we could see a doctor in Mexico. I said, “No. We are going to Kosair now!” I contacted our family doctor and talked with the nurse practitioner on call. [gringoslocos6.com]

    Various associations have been made between breath holding spells such as convulsions, cardiac abnormalities, and iron deficiency anemia.[1] Convulsions are associated with breath holding spells due to extreme anoxia. [aaemrsa.blogspot.com]

    "I noticed the signs of an impending pass out, except this time, she started convulsing. Her arms were out straight, stiff and wouldn't go down." The restaurant staff called 911 and by the time paramedics arrived, the toddler was convulsing. [abcnews.go.com]

  • Behavior Problem

    The episodes are not behavioral, but if the child learns that when he starts crying he gets his way, he may develop behavior problems. [childneurologyfoundation.org]

    This can lead to behavior problems that may last even after she’s outgrown her breath-holding spells. [webmd.com]

    "Medical problems can be expressed at this time." Kids Will Grow Out of Bad Behaviors But Ayoob pointed out that, without a solid underlying problem resulting in BHS, there is little treatment available. [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]

  • Febrile Seizures

    Febrile Seizures – parents often describe their child’s first febrile seizure as ‘the worst moment of their life.’ [keepkidshealthy.com]

Treatment

Piracetam is an effective prophylactic treatment for severe BHS. [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]

After the spell, the heart speeds up again, breathing restarts, and consciousness returns without any treatment. Because this form is rare, further diagnostic evaluation and treatment may be needed if the spells occur often. [merckmanuals.com]

Breath-holding spells is a relatively common disorder in young children that usually spontaneously resolves and needs no treatment. [circ.ahajournals.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]

[…] v=oknV2XZt9Uw Epidemiology Occurs in approximately 5% of the population with equal distribution between males and females. Most common between 6-18 months and usually not present after 5 years of age. [pedclerk.bsd.uchicago.edu]

Pathophysiology

Prior research concerning the underlying pathophysiologic mechanisms involved in breath-holding spells has implicated an autonomic nervous system dysregulation. [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]

Prevention

Often, the spells can be predicted and even prevented from occurring once the factors that trigger them have been identified. [news-medical.net]

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]

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]

Distracting children and avoiding situations that lead to tantrums are the best ways of preventing and treating these spells. [merckmanuals.com]

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