Materiały źródłowe

• #1 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Breath-holding spells commonly affect up to 5% of all infants. While they are benign, they might be a frightening experience for children and, consequently, for their caregivers. Breath-holding spells occur in children with benign neurological examination findings and children who meet age-appropriate developmental milestones. Typically breath-holding spells do not affect the subsequent neurological development of a child. […] While benign, knowing these spells’ pathophysiology and differential diagnosis is essential so other pathological conditions may be ruled out. This activity reviews the evaluation of breath-holding episodes and the role of the interprofessional team in managing this condition and educating the parents. […] A breath-holding spell is a common benign phenomenon that affects up to 5% of children. These spells can be a frightening experience for children as well as parents. These spells are broken down into 2 types: cyanotic and pallid.

• #2 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  Background: Breath-holding spells are common, frightening, but fortunately benign events. Familiarity with this condition is important so that an accurate diagnosis can be made. […] Objective: To familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of children with breath-holding spells. […] Breath-holding spells affect 0.1 to 4.6% of otherwise healthy young children. The onset is usually between 6 and 18 months of age. […] The spells usually disappear spontaneously by 5 years of age. […] A detailed history is the mainstay of diagnosis. A characteristic sequence of events is usually enough to distinguish this condition from other disorders. […] In pallid breath-holding spells, the events may be reproducible with ocular compression for 10 seconds and bradycardia demonstrated.

• #3 Breath-holding spells – UpToDate

  https://www.uptodate.com/contents/breath-holding-spells/print

  Breath-holding spells (BHS) are frightening but innocuous episodic events that can affect infants and young children. The two clinical types are cyanotic and pallid. Both types are typically preceded or provoked by an injury or emotional upset. Brief unresponsiveness, loss of consciousness, or seizures may result. […] The pathogenesis of BHS events is not clear. Some studies support a primary role for dysfunction of the autonomic nervous system. Iron deficiency anemia is more prevalent in children with BHS compared with controls and might contribute to the occurrence of BHS and the underlying dysautonomia. A family history of BHS is present in 20 to 35 percent of patients, and an autosomal dominant trait has been reported in some families. […] BHS are relatively common events in otherwise healthy infants and young children.

• #4 What Are Breath-Holding Spells in Kids? | Children’s Hospital Colorado

  https://www.childrenscolorado.org/just-ask-childrens/articles/breath-holding-spells/

  Watching your child have a breath-holding spell can be scary and overwhelming. These spells occur in about 5% of healthy children, and about 20% to 33% of children with breath-holding spells have a family history of them. […] A breath-holding spell is when your child or baby holds their breath for long enough that they temporarily stop breathing, which sometimes causes them to pass out. […] It is important to know that this is something a child cant control, and you cant prevent them from occurring. […] Breath-holding spells usually stop happening by age 6. Its important to know that children under the age of 6 months do not have breath-holding spells and should be immediately evaluated by a doctor if a caregiver thinks their baby stopped breathing. […] You should talk to your childs doctor if you think that your child had a breath-holding spell. Some children with breath-holding spells may have low iron or blood levels (anemia). Your childs doctor may want to run additional tests and can help determine if your child has breath-holding spells or another diagnosis, such as seizures which can sometimes appear similar to a breath-holding spell.

• #5 Breath holding

  https://www.rch.org.au/kidsinfo/fact_sheets/breath_holding/

  Breath holding is common, especially in children aged six months to six years old. When your child holds their breath, it is often called a spell. Breath-holding spells can happen after your child has had a fright or a minor accident, or when they are scolded, frustrated or very upset. […] Breath holding is frightening and distressing for parents and witnesses. It is important to remember the spell is not harmful and your child will start breathing again on their own. […] Most children who have breath-holding spells will have their first spell before they are 18 months old, and most children grow out of breath holding by the time they are six years old. Children who breath hold will usually have one to six spells per week, but up to 25 percent of children who breath hold will have multiple spells each day.

• #6 Breath holding

  https://www.rch.org.au/kidsinfo/fact_sheets/breath_holding/

  There are two main types of breath holding: blue spells and pale spells. Both types of spells only last a few seconds, are do not cause any long-term damage. […] Blue spells are the most common. Your child may have hurt themselves or become very upset or frustrated, and they will: cry or scream, breathe out forcefully, then breath hold and turn blue, especially around the lips this blueness is caused by a lack of oxygen, and lasts a few seconds, may then become floppy and lose consciousness (faint). […] Although this is scary to watch, no treatment is needed. There is no need to splash your child with cold water or blow air in their face. No long-term damage is done due to the brief period with reduced blood oxygen levels. […] These are less common. They can happen in young children after a minor injury or if the child is upset. Pale spells are caused by a slow heart rate and are often mistaken for a seizure. Your child will: open their mouth as if to cry but no sound comes out, faint and look very pale, have a brief period where their arms and legs become stiff or lose control of their bladder/bowel.

• #7 Breath holding

  https://www.rch.org.au/kidsinfo/fact_sheets/breath_holding/

  Breath holding is common, especially in children aged six months to six years old. When your child holds their breath, it is often called a spell. Breath-holding spells can happen after your child has had a fright or a minor accident, or when they are scolded, frustrated or very upset. […] Breath holding is frightening and distressing for parents and witnesses. It is important to remember the spell is not harmful and your child will start breathing again on their own. […] Most children who have breath-holding spells will have their first spell before they are 18 months old, and most children grow out of breath holding by the time they are six years old. Children who breath hold will usually have one to six spells per week, but up to 25 percent of children who breath hold will have multiple spells each day.

• #8 Breath-holding in babies and children

  https://www.nhs.uk/conditions/breath-holding-in-babies-and-children/

  Breath-holding is when a baby or child stops breathing for up to 1 minute and may faint. It can happen when a child is frightened, upset, angry, or has a sudden shock or pain. It’s usually harmless but can be scary for parents, particularly when it happens for the first time. […] If a doctor has not previously told you it’s breath-holding, it’s important to get it checked immediately. […] Breath-holding can be scary for parents, but it’s usually harmless and your child should grow out of it by the age of 4 or 5. […] Your child is not holding their breath on purpose and cannot control what happens when they have a breath-holding episode. […] The GP will try to find out if there’s a more serious underlying condition. They may suggest your child has an ECG to check their heart rhythm. […] There’s no specific treatment for breath-holding. It should eventually stop by the time your child is 4 or 5 years old. […] Breath-holding is not something a child does deliberately.

• #9 Breath-holding spells – UpToDate

  https://www.uptodate.com/contents/breath-holding-spells

  Breath-holding spells (BHS) are frightening but innocuous episodic events that can affect infants and young children. The two clinical types are cyanotic and pallid. Both types are typically preceded or provoked by an injury or emotional upset. Brief unresponsiveness, loss of consciousness, or seizures may result. […] The pathogenesis of BHS events is not clear. Some studies support a primary role for dysfunction of the autonomic nervous system. Iron deficiency anemia is more prevalent in children with BHS compared with controls and might contribute to the occurrence of BHS and the underlying dysautonomia. An association between BHS and other types of anemia, including transient erythroblastopenia of childhood (TEC), has also been described. […] BHS are relatively common events in otherwise healthy infants and young children.

• #10 Breath-holding in babies and children

  https://www.nhs.uk/conditions/breath-holding-in-babies-and-children/

  Breath-holding is when a baby or child stops breathing for up to 1 minute and may faint. It can happen when a child is frightened, upset, angry, or has a sudden shock or pain. It’s usually harmless but can be scary for parents, particularly when it happens for the first time. […] If a doctor has not previously told you it’s breath-holding, it’s important to get it checked immediately. […] Breath-holding can be scary for parents, but it’s usually harmless and your child should grow out of it by the age of 4 or 5. […] Your child is not holding their breath on purpose and cannot control what happens when they have a breath-holding episode. […] The GP will try to find out if there’s a more serious underlying condition. They may suggest your child has an ECG to check their heart rhythm. […] There’s no specific treatment for breath-holding. It should eventually stop by the time your child is 4 or 5 years old. […] Breath-holding is not something a child does deliberately.

• #11 Breath-Holding Spells – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/behavioral-problems-in-children/breath-holding-spells

  A breath-holding spell is an episode in which the child involuntarily stops breathing and loses consciousness for a short period immediately after a frightening or emotionally upsetting event or a painful experience. […] Breath-holding spells usually are triggered by physically painful or emotionally upsetting events. […] Typical symptoms include paleness, stoppage of breathing, loss of consciousness, and seizures. […] Despite the dramatic nature of the symptoms, the spells are not dangerous. […] Breath-holding spells occur in less than 1% to about 5% of otherwise healthy children. […] A small percentage of these children may continue to have spells into adulthood. […] Both the cyanotic and pallid forms are involuntary, which means that children are not intentionally holding their breath and have no control over the spells.

• #12 Breath-holding spells – UpToDate

  https://www.uptodate.com/contents/breath-holding-spells

  Breath-holding spells (BHS) are frightening but innocuous episodic events that can affect infants and young children. The two clinical types are cyanotic and pallid. Both types are typically preceded or provoked by an injury or emotional upset. Brief unresponsiveness, loss of consciousness, or seizures may result. […] The pathogenesis of BHS events is not clear. Some studies support a primary role for dysfunction of the autonomic nervous system. Iron deficiency anemia is more prevalent in children with BHS compared with controls and might contribute to the occurrence of BHS and the underlying dysautonomia. An association between BHS and other types of anemia, including transient erythroblastopenia of childhood (TEC), has also been described. […] BHS are relatively common events in otherwise healthy infants and young children.

• #13 Briefs: Breath holding spells – PEMBlog

  https://pemcincinnati.com/blog/briefs-breath-holding-spells-2/

  The diagnosis of breath holding spells can be made clinically in almost all cases. This diagnosis does require that you have no concerns for significant TBI, and that the vital signs, and the cardiac, pulmonary and neurologic exams are normal. Obtaining a clear history of what occurred before the event is quite important. If you are not 100% certain of the diagnosis an EKG to rule out long QT would be an appropriate test. Some studies have indicated that children with iron deficiency anemia may be more prone to breath holding spells. Testing of a hemoglobin level is an option in the ED, but it would also be appropriate to have this done at the childs PMD. It is theorized that anemia may increase a childs vulnerability to hypoxia. Iron also plays a part in catecholamine metabolism and neurotransmitter function, and therefore a deficiency may affect autoregulation of neurocardiogenic function as well.

• #14 Breath holding

  https://www.rch.org.au/kidsinfo/fact_sheets/breath_holding/

  There are two main types of breath holding: blue spells and pale spells. Both types of spells only last a few seconds, are do not cause any long-term damage. […] Blue spells are the most common. Your child may have hurt themselves or become very upset or frustrated, and they will: cry or scream, breathe out forcefully, then breath hold and turn blue, especially around the lips this blueness is caused by a lack of oxygen, and lasts a few seconds, may then become floppy and lose consciousness (faint). […] Although this is scary to watch, no treatment is needed. There is no need to splash your child with cold water or blow air in their face. No long-term damage is done due to the brief period with reduced blood oxygen levels. […] These are less common. They can happen in young children after a minor injury or if the child is upset. Pale spells are caused by a slow heart rate and are often mistaken for a seizure. Your child will: open their mouth as if to cry but no sound comes out, faint and look very pale, have a brief period where their arms and legs become stiff or lose control of their bladder/bowel.

• #15 Breath holding

  https://www.rch.org.au/kidsinfo/fact_sheets/breath_holding/

  There are two main types of breath holding: blue spells and pale spells. Both types of spells only last a few seconds, are do not cause any long-term damage. […] Blue spells are the most common. Your child may have hurt themselves or become very upset or frustrated, and they will: cry or scream, breathe out forcefully, then breath hold and turn blue, especially around the lips this blueness is caused by a lack of oxygen, and lasts a few seconds, may then become floppy and lose consciousness (faint). […] Although this is scary to watch, no treatment is needed. There is no need to splash your child with cold water or blow air in their face. No long-term damage is done due to the brief period with reduced blood oxygen levels. […] These are less common. They can happen in young children after a minor injury or if the child is upset. Pale spells are caused by a slow heart rate and are often mistaken for a seizure. Your child will: open their mouth as if to cry but no sound comes out, faint and look very pale, have a brief period where their arms and legs become stiff or lose control of their bladder/bowel.

• #16 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  The frequency of these episodes can be decreased by distracting the child, avoiding emotional triggers, and providing psychosocial help to parents and children. […] In addition, it is important to rule out certain conditions such as iron deficiency anemia and long QT syndrome when assessing a child and to follow up on any other red flags with a more detailed workup. […] The diagnosis is usually made from the description of the episode. A history of any inciting event should be elicited, especially to distinguish any seizure disorder, as history is typical for breath-holding spells. […] Iron studies should be obtained as iron deficiency is prevalent among these children. An EKG is another mainstay of evaluation to rule out a potentially important cardiac cause of these spells. […] Distinguishing seizure disorders from breath-holding spells may be confusing; therefore, an electroencephalogram (EEG) may be performed.

• #17 Breath Holding Spells: Do This When Your Upset Child Hoods Breath

  https://www.webmd.com/children/children-breath-holding

  If your young child reacts to sudden pain or upset by not breathing, turning blue or pale, and then fainting, they may have just had a breath-holding spell. […] After your child’s first breath-holding spell, take them to their doctor to rule out any health problems. […] There are no tests to confirm a breath-holding spell. Your pediatrician usually can diagnose it after hearing what happened. […] Rarely, the pediatrician may refer your child to a heart doctor, called a cardiologist, or to a neurologist, who specializes in the brain and the nervous system, to check for any underlying causes.

• #18 Breath holding spell Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/breath-holding-spell

  Some children have breath-holding spells. This is an involuntary stop in breathing that is not in the child’s control. […] Babies as young as 2 months old and up to 2 years old can start having breath-holding spells. Some children have severe spells. […] Breath-holding spells most often occur when a child becomes suddenly upset or surprised. The child makes a short gasp, exhales, and stops breathing. The child’s nervous system slows the heart rate or breathing for a short amount of time. […] Your health care provider will perform a physical exam and ask questions about your child’s medical history and symptoms. […] Most children outgrow breath-holding spells by the time they are 4 to 8 years old. […] Contact your child’s provider if you think your child is having breath-holding spells.

• #19 Breath-Holding Spells Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/breath-holding-spells/

  Breath-holding spells are brief periods when young children stop breathing for up to 1 minute. These spells often cause a child to pass out (lose consciousness). Breath-holding spells usually occur when a young child is angry, frustrated, in pain, or afraid. But the spell is a reflex. Children don’t have breath-holding spells on purpose. […] Doctors can usually diagnose breath-holding spells based on what happens during a spell. The doctor will examine your child and ask you to describe the spells. It may help for you to keep a record of what happens during each spell. […] If your doctor thinks that your child has a seizure disorder or another condition, such as iron deficiency anemia, your child may need other tests.

• #20 Breath-holding spells: Scary but not serious

  https://www.contemporarypediatrics.com/view/breath-holding-spells-scary-not-serious

  Understanding the characteristics of breath-holding spells and how to differentiate them from serious conditions will help you reassure parents so they can better deal with these alarming but benign episodes. […] Breath-holding spells follow a stereotyped sequence. The spell is provoked by something that causes anger, frustration, pain, or surprise, quickly followed by crying. […] Breath-holding spells that begin at a younger or older age than is customary call for special attention. In the neonatal period, when spells may start during feeding and diaper changing, breath-holding spells are a diagnosis of exclusion, calling for an extensive workup to eliminate major central nervous system, cardiac, respiratory, and metabolic causes of cyanotic spells. […] The most common entity in the differential diagnosis of both cyanotic and pallid breath-holding spells is epilepsy.

• #21 What Are Breath-Holding Spells in Kids? | Children’s Hospital Colorado

  https://www.childrenscolorado.org/just-ask-childrens/articles/breath-holding-spells/

  Watching your child have a breath-holding spell can be scary and overwhelming. These spells occur in about 5% of healthy children, and about 20% to 33% of children with breath-holding spells have a family history of them. […] A breath-holding spell is when your child or baby holds their breath for long enough that they temporarily stop breathing, which sometimes causes them to pass out. […] It is important to know that this is something a child cant control, and you cant prevent them from occurring. […] Breath-holding spells usually stop happening by age 6. Its important to know that children under the age of 6 months do not have breath-holding spells and should be immediately evaluated by a doctor if a caregiver thinks their baby stopped breathing. […] You should talk to your childs doctor if you think that your child had a breath-holding spell. Some children with breath-holding spells may have low iron or blood levels (anemia). Your childs doctor may want to run additional tests and can help determine if your child has breath-holding spells or another diagnosis, such as seizures which can sometimes appear similar to a breath-holding spell.

• #22 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  The differential diagnosis of breath-holding spells is listed in Table 1. The differentiation of breath-holding spells from epilepsy is important to avoid the initiation of inappropriate anticonvulsant medications as well as the unwarranted stigmata associated with epilepsy. […] In the setting of a typical history and a normal physical examination, laboratory evaluation is usually not necessary in patients with cyanotic breath-holding spells. […] Breath-holding spells can be very distressful for parents and may have an adverse effect on their quality of life. […] As far as the child is concerned, breath-holding spells are benign and no sequelae is expected. […] Breath-holding spells are frightening and stressful to parents. Confident reassurance and frank explanation are cornerstones of treatment. […] It has been shown that iron supplementation in children with breath-holding spells and concomitant iron deficiency anemia or iron deficiency is effective in decreasing the frequency and severity of the breath-holding spells. […] Children with breath-holding spells have an excellent prognosis.

• #23 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  The frequency of these episodes can be decreased by distracting the child, avoiding emotional triggers, and providing psychosocial help to parents and children. […] In addition, it is important to rule out certain conditions such as iron deficiency anemia and long QT syndrome when assessing a child and to follow up on any other red flags with a more detailed workup. […] The diagnosis is usually made from the description of the episode. A history of any inciting event should be elicited, especially to distinguish any seizure disorder, as history is typical for breath-holding spells. […] Iron studies should be obtained as iron deficiency is prevalent among these children. An EKG is another mainstay of evaluation to rule out a potentially important cardiac cause of these spells. […] Distinguishing seizure disorders from breath-holding spells may be confusing; therefore, an electroencephalogram (EEG) may be performed.

• #24 Breath-holding spell: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000967.htm

  Some children have breath-holding spells. This is an involuntary stop in breathing that is not in the child’s control. […] Babies as young as 2 months old and up to 2 years old can start having breath-holding spells. Some children have severe spells. […] Breath-holding spells are more common in children with: Genetic conditions, such as Riley-Day syndrome or Rett syndrome; Iron deficiency anemia; A family history of breath-holding spells (parents may have had similar spells when they were children). […] Breath-holding spells most often occur when a child becomes suddenly upset or surprised. The child makes a short gasp, exhales, and stops breathing. […] Your health care provider will perform a physical exam and ask questions about your child’s medical history and symptoms. Blood tests may be done to check for an iron deficiency. Other tests that may be done include: Electrocardiogram (ECG) to check the heart; Electroencephalogram (EEG) to check for seizures. […] Most children outgrow breath-holding spells by the time they are 4 to 8 years old. […] Contact your child’s provider if: You think your child is having breath-holding spells; Your child’s breath-holding spells are getting worse or happening more often.

• #25 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  The frequency of these episodes can be decreased by distracting the child, avoiding emotional triggers, and providing psychosocial help to parents and children. […] In addition, it is important to rule out certain conditions such as iron deficiency anemia and long QT syndrome when assessing a child and to follow up on any other red flags with a more detailed workup. […] The diagnosis is usually made from the description of the episode. A history of any inciting event should be elicited, especially to distinguish any seizure disorder, as history is typical for breath-holding spells. […] Iron studies should be obtained as iron deficiency is prevalent among these children. An EKG is another mainstay of evaluation to rule out a potentially important cardiac cause of these spells. […] Distinguishing seizure disorders from breath-holding spells may be confusing; therefore, an electroencephalogram (EEG) may be performed.

• #26 Breath-holding spell – Wikipedia

  https://en.wikipedia.org/wiki/Breath-holding_spell

  Breath-holding spells (BHS) are the occurrence of episodic apnea in children, possibly associated with syncope (loss of consciousness and changes in postural tone). […] The diagnosis of a breath-holding spell is made clinically. A good history including the sequence of events, lack of incontinence and no postictal phase, help to make an accurate diagnosis. […] Some families are advised to make a video recording of the events to aid diagnosis. […] Two articles on breath-holding spells strongly suggest that parents consider having their child be tested by electrocardiogram for the rare, but real possibility that the BHS episodes are actually a symptom of prolonged QT-syndrome, a serious but treatable form of cardiac arrhythmia.

• #27 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  The frequency of these episodes can be decreased by distracting the child, avoiding emotional triggers, and providing psychosocial help to parents and children. […] In addition, it is important to rule out certain conditions such as iron deficiency anemia and long QT syndrome when assessing a child and to follow up on any other red flags with a more detailed workup. […] The diagnosis is usually made from the description of the episode. A history of any inciting event should be elicited, especially to distinguish any seizure disorder, as history is typical for breath-holding spells. […] Iron studies should be obtained as iron deficiency is prevalent among these children. An EKG is another mainstay of evaluation to rule out a potentially important cardiac cause of these spells. […] Distinguishing seizure disorders from breath-holding spells may be confusing; therefore, an electroencephalogram (EEG) may be performed.

• #28 Breath-Holding Spells in Infants: Crucial Points

  https://flo.health/being-a-mom/your-baby/baby-health-and-safety/breath-holding-spells-in-infants

  Breath-holding spells (benign paroxysmal nonepileptic disorder) are episodes in which a child cries because he is hurt, frightened, or upset, then turns pale or blue and loses consciousness. […] It’s important that you seek expert medical advice after the first occasion of a breath-holding spell. Your baby’s pediatrician will conduct a thorough examination to look for any evidence of a more serious underlying condition. Your doctor may want to perform an ECG to check for an irregular heartbeat. […] While a breath-holding episode may look like a seizure, there are no seizure discharges seen on the electroencephalogram (EEG) recording of the brain. Therefore, a child experiencing an episode does not need to be treated with seizure medication.

• #29 Breath holding spells: Types, causes, and prevention

  https://www.medicalnewstoday.com/articles/breath-holding-spells

  A child that regularly has breath holding spells should have a checkup with a healthcare professional to rule out medical conditions. […] Most children will grow out of breath holding by the time they are 6 years old. The episodes are usually harmless and do not need medical investigation. However, caregivers should consult a doctor in the following circumstances: the child is younger than 6 months; spells happen more than once per week; breath holding begins suddenly; the child looks confused and excessively drowsy after holding their breath; the child shakes and goes rigid for longer than 1 minute, and they take a while to recover; the child falls and hits their head during a spell. […] If a child holds their breath frequently or an episode happens before they are 6 months old, caregivers should consult a doctor.

• #30 Children with breath-holding spells undergo unnecessary diagnostic interventions: Study

  https://medicalxpress.com/news/2023-11-children-breath-holding-unnecessary-diagnostic-interventions.html

  The Lund University study examined more than 500 children who had been diagnosed with breath-holding spells in SkÃ¥ne Region in Southern Sweden, between 2004 and 2018. Almost half of the children were investigated with an ECG, which measures the electrical activity of the heart, and a third with an EEG, which measures the electrical activity of the brain. None of these ECG and EEG investigations in the study showed abnormal test results which could explain the spells in these children. […] „These unjustified diagnostic interventions are stressful for both children and their parents and can cause unnecessary worry. Furthermore, it uses health care resources that could be used elsewhere.” […] The new guidelines will make it clearer when children need an ECG and when they should have a blood test to check their blood count and iron status.

• #31 Children with breath-holding spells undergo unnecessary diagnostic interventions | Lund University

  https://www.lunduniversity.lu.se/article/children-breath-holding-spells-undergo-unnecessary-diagnostic-interventions

  These unjustified diagnostic interventions are stressful for both children and their parents and can cause unnecessary worry. […] It may seem a bit controversial to suggest fewer diagnostic tests, but with an accurate and detailed patient medical history and background information on what happened to the child, the doctor can easily diagnose breath-holding spells without these tests, argues Sanna Hellstrm Schmidt. […] The new guidelines will make it clearer when children need an ECG and when they should have a blood test to check their blood count and iron status. […] We expect the number of ECG investigations to decrease significantly with our guidelines, and the use of EEG is not suggested at all.

• #32 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  The differential diagnosis of breath-holding spells is listed in Table 1. The differentiation of breath-holding spells from epilepsy is important to avoid the initiation of inappropriate anticonvulsant medications as well as the unwarranted stigmata associated with epilepsy. […] In the setting of a typical history and a normal physical examination, laboratory evaluation is usually not necessary in patients with cyanotic breath-holding spells. […] Breath-holding spells can be very distressful for parents and may have an adverse effect on their quality of life. […] As far as the child is concerned, breath-holding spells are benign and no sequelae is expected. […] Breath-holding spells are frightening and stressful to parents. Confident reassurance and frank explanation are cornerstones of treatment. […] It has been shown that iron supplementation in children with breath-holding spells and concomitant iron deficiency anemia or iron deficiency is effective in decreasing the frequency and severity of the breath-holding spells. […] Children with breath-holding spells have an excellent prognosis.

• #33 Breath-Holding Spells – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/behavioral-problems-in-children/breath-holding-spells

  A doctor may recommend iron supplements for a child who has cyanotic breath-holding spells, even when the child does not have iron-deficiency anemia, and treatment for obstructive sleep apnea (if the child has it). […] Because this form causes symptoms similar to those of certain heart and brain disorders, doctors may need to do a diagnostic evaluation to rule out those disorders if the spells occur often.

• #34 Breath-holding spells: Scary but not serious

  https://www.contemporarypediatrics.com/view/breath-holding-spells-scary-not-serious

  Understanding the characteristics of breath-holding spells and how to differentiate them from serious conditions will help you reassure parents so they can better deal with these alarming but benign episodes. […] Breath-holding spells follow a stereotyped sequence. The spell is provoked by something that causes anger, frustration, pain, or surprise, quickly followed by crying. […] Breath-holding spells that begin at a younger or older age than is customary call for special attention. In the neonatal period, when spells may start during feeding and diaper changing, breath-holding spells are a diagnosis of exclusion, calling for an extensive workup to eliminate major central nervous system, cardiac, respiratory, and metabolic causes of cyanotic spells. […] The most common entity in the differential diagnosis of both cyanotic and pallid breath-holding spells is epilepsy.

• #35 Breath-holding spell – WikEM

  https://wikem.org/wiki/Breath-holding_spell

  Episode during which child holds breath, usually during excessive crying upon exhalation. […] Typically occur in children 6-18mo but can be up to 6yo. […] Occur in 5% of all children. […] Consider if BRUE or seizure workup warranted. […] Some evidence of increased QT dispersion in children with breath holding spells. […] No specific treatment. […] Reassurance- benign phenomena that does not typically result in injury and will resolve with time. […] Do not need cardiology or neurology outpatient referrals.

• #36 Breath-holding spells: Scary but not serious

  https://www.contemporarypediatrics.com/view/breath-holding-spells-scary-not-serious

  Understanding the characteristics of breath-holding spells and how to differentiate them from serious conditions will help you reassure parents so they can better deal with these alarming but benign episodes. […] Breath-holding spells follow a stereotyped sequence. The spell is provoked by something that causes anger, frustration, pain, or surprise, quickly followed by crying. […] Breath-holding spells that begin at a younger or older age than is customary call for special attention. In the neonatal period, when spells may start during feeding and diaper changing, breath-holding spells are a diagnosis of exclusion, calling for an extensive workup to eliminate major central nervous system, cardiac, respiratory, and metabolic causes of cyanotic spells. […] The most common entity in the differential diagnosis of both cyanotic and pallid breath-holding spells is epilepsy.

• #37 Children with breath-holding spells undergo unnecessary diagnostic interventions: Study

  https://medicalxpress.com/news/2023-11-children-breath-holding-unnecessary-diagnostic-interventions.html

  Breath-holding spells are common in young children and are benign. Yet children often undergo unnecessary diagnostic interventions when seeking medical care. This is because there are no national or international guidelines on how to assess children in these cases. […] While breath-holding spells are a familiar concept in health care, there are no diagnostic criteria or guidelines on how to assess these children when they seek medical care. This leads to uncertainty about how to investigate and take care of the patients, and also what might be an appropriate follow-up. […] „This is why we need clear diagnostic criteria, to standardize assessment and treatment. At present, many doctors treat these spells as something between a first-time seizure and a fainting episode, which is not correct.”

• #38 Children with breath-holding spells undergo unnecessary diagnostic interventions | Lund University

  https://www.lunduniversity.lu.se/article/children-breath-holding-spells-undergo-unnecessary-diagnostic-interventions

  Breath-holding spells are common in young children and are benign. Yet children often undergo unnecessary diagnostic interventions when seeking medical care. This is because there are no national or international guidelines on how to assess children in these cases. […] While breath-holding spells are a familiar concept in healthcare, there are no diagnostic criteria or guidelines on how to assess these children when they seek medical care. This leads to uncertainty about how to investigate and take care of the patients, and also what might be an appropriate follow-up. […] This is why we need clear diagnostic criteria, to standardise assessment and treatment. […] The Lund University study examined more than 500 children who had been diagnosed with breath-holding spells in Skne Region in Southern Sweden, between 2004 and 2018.

• #39 Children with breath-holding spells undergo unnecessary diagnostic interventions | Lund University

  https://www.lunduniversity.lu.se/article/children-breath-holding-spells-undergo-unnecessary-diagnostic-interventions

  These unjustified diagnostic interventions are stressful for both children and their parents and can cause unnecessary worry. […] It may seem a bit controversial to suggest fewer diagnostic tests, but with an accurate and detailed patient medical history and background information on what happened to the child, the doctor can easily diagnose breath-holding spells without these tests, argues Sanna Hellstrm Schmidt. […] The new guidelines will make it clearer when children need an ECG and when they should have a blood test to check their blood count and iron status. […] We expect the number of ECG investigations to decrease significantly with our guidelines, and the use of EEG is not suggested at all.

• #40 Children with breath-holding spells undergo unnecessary diagnostic interventions | Lund University

  https://www.lunduniversity.lu.se/article/children-breath-holding-spells-undergo-unnecessary-diagnostic-interventions

  These unjustified diagnostic interventions are stressful for both children and their parents and can cause unnecessary worry. […] It may seem a bit controversial to suggest fewer diagnostic tests, but with an accurate and detailed patient medical history and background information on what happened to the child, the doctor can easily diagnose breath-holding spells without these tests, argues Sanna Hellstrm Schmidt. […] The new guidelines will make it clearer when children need an ECG and when they should have a blood test to check their blood count and iron status. […] We expect the number of ECG investigations to decrease significantly with our guidelines, and the use of EEG is not suggested at all.

• #41 Children with breath-holding spells undergo unnecessary diagnostic interventions | Lund University

  https://www.lunduniversity.lu.se/article/children-breath-holding-spells-undergo-unnecessary-diagnostic-interventions

  These unjustified diagnostic interventions are stressful for both children and their parents and can cause unnecessary worry. […] It may seem a bit controversial to suggest fewer diagnostic tests, but with an accurate and detailed patient medical history and background information on what happened to the child, the doctor can easily diagnose breath-holding spells without these tests, argues Sanna Hellstrm Schmidt. […] The new guidelines will make it clearer when children need an ECG and when they should have a blood test to check their blood count and iron status. […] We expect the number of ECG investigations to decrease significantly with our guidelines, and the use of EEG is not suggested at all.

• #42 Breath-holding spells: Scary but not serious

  https://www.contemporarypediatrics.com/view/breath-holding-spells-scary-not-serious

  An EEG is not typically part of the workup for breath-holding spells, unless clinical findings suggest epilepsy. […] The only diagnostic tests to consider are an EKG to rule out prolonged QT interval and a complete blood count with serum ferritin to look for iron deficiency. […] In about half of children with breath-holding spells, the episodes resolve by age 5 years. […] Despite EEG changes associated with hypoxia, children who have breath-holding spells are not at risk for central nervous system sequelae. […] The most important aspect of treatment, then, is to reassure the family that the episodes are harmless. Parents need to know that the episodes are involuntary and that the child will begin breathing spontaneously without parental action. […] If your child is older than 2 years and is having daily spells, however, he probably has learned to trigger some of them himself. […] Call our office now if: Your child holds his breath for more than one minute (by the clock) or his spells are different from those described here.

• #43 Breath-holding spells: Scary but not serious

  https://www.contemporarypediatrics.com/view/breath-holding-spells-scary-not-serious

  An EEG is not typically part of the workup for breath-holding spells, unless clinical findings suggest epilepsy. […] The only diagnostic tests to consider are an EKG to rule out prolonged QT interval and a complete blood count with serum ferritin to look for iron deficiency. […] In about half of children with breath-holding spells, the episodes resolve by age 5 years. […] Despite EEG changes associated with hypoxia, children who have breath-holding spells are not at risk for central nervous system sequelae. […] The most important aspect of treatment, then, is to reassure the family that the episodes are harmless. Parents need to know that the episodes are involuntary and that the child will begin breathing spontaneously without parental action. […] If your child is older than 2 years and is having daily spells, however, he probably has learned to trigger some of them himself. […] Call our office now if: Your child holds his breath for more than one minute (by the clock) or his spells are different from those described here.

• #44 Breath-holding spells: Scary but not serious

  https://www.contemporarypediatrics.com/view/breath-holding-spells-scary-not-serious

  An EEG is not typically part of the workup for breath-holding spells, unless clinical findings suggest epilepsy. […] The only diagnostic tests to consider are an EKG to rule out prolonged QT interval and a complete blood count with serum ferritin to look for iron deficiency. […] In about half of children with breath-holding spells, the episodes resolve by age 5 years. […] Despite EEG changes associated with hypoxia, children who have breath-holding spells are not at risk for central nervous system sequelae. […] The most important aspect of treatment, then, is to reassure the family that the episodes are harmless. Parents need to know that the episodes are involuntary and that the child will begin breathing spontaneously without parental action. […] If your child is older than 2 years and is having daily spells, however, he probably has learned to trigger some of them himself. […] Call our office now if: Your child holds his breath for more than one minute (by the clock) or his spells are different from those described here.

• #45 Baby Breath Holding: Causes, Diagnosis, Treatment, and Outlook

  https://www.healthline.com/health/parenting/baby-holding-breath

  In some cases, breath holding may be related to iron deficiency anemia. In these cases, an iron supplement may help decrease the frequency of breath holding. […] If breath holding increases in frequency or interferes with daily activities, your childs doctor may refer them to a neurologist (brain specialist) and cardiologist (heart specialist). These healthcare professionals can rule out an underlying medical condition.

• #46 Breath-Holding Spells – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK539782/

  Breath-holding spells are not harmful and do not result in brain damage. Neurologic development outcome, if already normal, will remain normal. Most children will no longer have the episodes by age 6. […] Parents should be educated on handling the events and receive reassurance that breath-holding spells have no long-term effects.

• #47 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  The differential diagnosis of breath-holding spells is listed in Table 1. The differentiation of breath-holding spells from epilepsy is important to avoid the initiation of inappropriate anticonvulsant medications as well as the unwarranted stigmata associated with epilepsy. […] In the setting of a typical history and a normal physical examination, laboratory evaluation is usually not necessary in patients with cyanotic breath-holding spells. […] Breath-holding spells can be very distressful for parents and may have an adverse effect on their quality of life. […] As far as the child is concerned, breath-holding spells are benign and no sequelae is expected. […] Breath-holding spells are frightening and stressful to parents. Confident reassurance and frank explanation are cornerstones of treatment. […] It has been shown that iron supplementation in children with breath-holding spells and concomitant iron deficiency anemia or iron deficiency is effective in decreasing the frequency and severity of the breath-holding spells. […] Children with breath-holding spells have an excellent prognosis.

• #48 Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6696822/

  The differential diagnosis of breath-holding spells is listed in Table 1. The differentiation of breath-holding spells from epilepsy is important to avoid the initiation of inappropriate anticonvulsant medications as well as the unwarranted stigmata associated with epilepsy. […] In the setting of a typical history and a normal physical examination, laboratory evaluation is usually not necessary in patients with cyanotic breath-holding spells. […] Breath-holding spells can be very distressful for parents and may have an adverse effect on their quality of life. […] As far as the child is concerned, breath-holding spells are benign and no sequelae is expected. […] Breath-holding spells are frightening and stressful to parents. Confident reassurance and frank explanation are cornerstones of treatment. […] It has been shown that iron supplementation in children with breath-holding spells and concomitant iron deficiency anemia or iron deficiency is effective in decreasing the frequency and severity of the breath-holding spells. […] Children with breath-holding spells have an excellent prognosis.

• #49 Breath-Holding Spells – MD Searchlight

  https://mdsearchlight.com/child-health/breath-holding-spells/

  Typically, when it comes to diagnosing breath-holding spells in patients, there isnt a universally agreed-upon test or method. […] Its important to discuss anything that may have triggered the episode, as this could help to distinguish it from a seizure disorder. […] Doctors may also carry out iron level tests, as iron deficiency is common in kids who experience these spells. […] In addition, an EKG (a test checking for problems with the electrical activity of your heart) might be done to ensure that a cardiac condition isnt causing these episodes. […] Generally, scans like MRIs or CTs arent necessary because people experiencing these spells typically have normal brain structures. […] The prognosis for breath-holding spells is good. […] These episodes usually stop happening by the age of 6 and do not have any impact on the child’s future brain development. […] Studies have shown that there is no lasting brain damage associated with breath-holding spells.

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