Summary about Disease
Breath-holding spells are non-epileptic events characterized by involuntary cessation of breathing, often triggered by frustration, anger, pain, or fear. They primarily affect children between 6 months and 6 years of age. Although frightening to witness, they are generally benign and do not cause long-term harm.
Symptoms
Symptoms include:
Crying or whimpering followed by cessation of breathing
Change in skin color (turning blue/cyanotic or pale/pallid)
Brief loss of consciousness
Body stiffening or limpness
Possible brief jerking movements (resembling a seizure but typically not epileptic)
Causes
The exact cause is not fully understood, but potential factors include:
Autonomic nervous system immaturity or dysregulation
Iron deficiency anemia (in some cases)
Possible genetic predisposition
Triggering events like frustration, anger, pain, or fear
Medicine Used
There is no specific medication to stop breath-holding spells. Treatment focuses on managing underlying conditions and preventing triggers. Iron supplementation may be prescribed if iron deficiency anemia is present. In rare cases, a doctor may prescribe other medication if symptoms are very frequent or severe.
Is Communicable
No, breath-holding spells are not communicable. They are not caused by an infection or pathogen that can be transmitted from person to person.
Precautions
Remain calm during an episode.
Ensure the child is in a safe location to prevent injury if they lose consciousness.
Do not shake or try to stimulate the child during the spell.
Once the child regains consciousness, provide comfort and reassurance.
Identify and minimize potential triggers when possible.
If iron deficiency is present, follow the doctor's recommendations for iron supplementation.
How long does an outbreak last?
Breath-holding spells are not an "outbreak" in the sense of a contagious disease. Individual episodes are brief, lasting seconds to minutes. Most children outgrow breath-holding spells by 4-8 years of age. The frequency of spells can vary greatly from child to child, with some having them frequently and others only rarely.
How is it diagnosed?
Diagnosis is primarily clinical, based on a detailed history and observation of the events. A doctor will rule out other conditions that could cause similar symptoms, such as epilepsy or cardiac problems. Diagnostic tests may include:
Physical examination
Electrocardiogram (ECG) to rule out heart problems
Blood tests to check for iron deficiency anemia
Electroencephalogram (EEG) only if there is suspicion of seizures
Timeline of Symptoms
A typical breath-holding spell timeline: 1. Trigger: An event that causes frustration, anger, pain or fear. 2. Initial Response: Crying or whimpering. 3. Breath Holding: Cessation of breathing. 4. Color Change: Skin turning blue/cyanotic (cyanotic spells) or pale/pallid (pallid spells). 5. Loss of Consciousness: Occurs if breathing is not resumed. 6. Brief Jerking Movements (Optional): May occur as a result of oxygen deprivation to the brain. 7. Breathing Resumes: Spontaneous resumption of breathing. 8. Post-Episode: Drowsiness, confusion, or return to normal activity.
Important Considerations
While generally benign, it is essential to consult a doctor to rule out other potential causes of the symptoms.
Parental anxiety is common. Counseling and reassurance can be helpful.
Documenting the frequency and characteristics of the spells can assist the doctor in the diagnosis and management.
Avoid overreacting to the spells, as this can inadvertently reinforce the behavior.
Ensure caregivers (e.g., babysitters, teachers) are informed about the child's breath-holding spells and know how to respond.