Breath Holding Spells in Children:Definition,Types,Causes

4th Pediatric Infectious Diseases Conference

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Breath Holding Spells

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BREATH HOLDING SPELLS IN CHILDREN

Dr Ira Shah

M.D, DCH(Gold Medalist), FCPS, DNB

Q. My child (who has severe temper tantrums) in one of his tantrum suddenly became blue and became unconscious. My doctor says that he is suffering from a breath holding spell. What are breath holding spells ?
Breath holding spells or breath holding spasms are a benign, involuntary phenomenon seen in children between 6 months and 6 years of age. Either due to pain, fear or in anger frustration the child cries and then holds the breath.

Q. How do children with breath holding spells present ?
Breath holding spells occur only when the child is awake. There are 2 ways in which children with breath holding spells present

Cyanotic spells.

Pallid spells.

Cyanotic spells are the most common variety though some children may present with both the varieties (mixed)

Cyanotic spells :-They are often provoked by an upsetting situation, in anger or in frustration. The child usually cries or screams loudly and then the cry gradually becomes noiseless as child open the mouth and holds the breath in expiration for about 20 -30 sec (apnea). The child turns blue (cyanotic) and then the child may again start breathing or may proceed to lose consciousness. Sometimes, fits or seizure like activity may follow the loss of consciousness.

* The entire episode may last less than one minute and the child
generally regains full activity within a few minutes.

Pallid spells :- they are usually seen following a painful or fearful experience. The child becomes pale and often loses consciousness within a single gasp or cry.

Q. How common are breath holding spells ?
Breath holding spells are seen in 5% of children between 6 months to 6 years of age. They are commonly seen in children between 12 and 18 months and usually disappear by 4-5 years of age.

Q. How frequently does a child get an attack of breath holding spells ?
The frequency of breath holding spells may vary from 1-2 times in a month to several times in a day.

Q. Why does a child suffer from breath holding spells ?
Breath holding spell are an involuntary phenomenon (the child does not do it deliberately). They are usually seen in children with temper tantrums and other behavioral disorders.

Q. Do breath holding spells run in families ?
Yes, a positive family history may be found in about 25% of the cases.

Next : Breath Holding Spells(Contd.)

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