Breath-holding spells, described more than 400 years ago, are paroxysmal clinical events that occur between the ages of 6 months and 4 to 6 years in which vigorous crying is interrupted by end-expiratory apnea, followed by cyanosis or pallor, loss of consciousness, and occasionally by a clonic seizure or myoclonic movements. Though virtually always triggered by a stimulus (pain, fear, or anger), the misconception still exists that the child “does it on purpose.” The spells are terrifying to parents or caregivers but are often dismissed by clinicians in a cavalier manner due to their benign long-term outcome and the misconception that they occur in “spoiled children.”
In this article, Dr. Felicia Gliksman of Hackensack University Medical Center, Hackensack Meridian Health School of Medicine discusses studies regarding presumed autonomic dysregulation, rare occurrences of asystole, and seizures. Dr. Gliksman also expands on recent studies proposing possible treatment options in children with breath-holding spells.
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