https://wikem.org/w/index.php?action=history&feed=atom&title=Breath-holding_spellBreath-holding spell - Revision history2026-04-18T09:20:36ZRevision history for this page on the wikiMediaWiki 1.38.2https://wikem.org/w/index.php?title=Breath-holding_spell&diff=224965&oldid=prevClaireLewis: Created page with "==Background== *Episode during which child holds breath, usually during excessive crying upon exhalation *May occur after painful/scary/irritating event or after being discipl..."2019-08-18T17:30:14Z<p>Created page with "==Background== *Episode during which child holds breath, usually during excessive crying upon exhalation *May occur after painful/scary/irritating event or after being discipl..."</p>
<p><b>New page</b></p><div>==Background==<br />
*Episode during which child holds breath, usually during excessive crying upon exhalation<br />
*May occur after painful/scary/irritating event or after being disciplined or becoming angry<br />
*'''Not''' intentional e.g. child is not trying to pass out<ref>Goldman RD. Breath-holding spells in infants. Can Fam Physician. 2015 Feb;61(2):149-50. PMID: 25676645</ref><br />
*Typically occur in children 6-18mo but can be up to 6yo<br />
*Occur in 5% of all children<ref>https://pedemmorsels.com/breath-holding-spell/</ref><br />
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==Clinical Features==<br />
*Breath-holding during crying or intense emotion<br />
*May be associated with:<br />
**[[Syncope (peds)|Syncope]]<br />
***LOC brief, spontaneously resolves<br />
***May have brief [[seizure (peds)|seizure]]-like activity, but NO postictal period<br />
**Cyanosis<br />
**Pallor<br />
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==Differential Diagnosis==<br />
*[[Seizure]]<br />
*Toxicological (stimulants or depressant)<br />
*[[CO poisoning ]]<br />
*[[Breath-holding spell]]<br />
*[[Tet spell]]<br />
*[[congenital heart disease|Cardiac disease]]<br />
*Pregnancy (especially ectopic)<br />
*[[Hypoglycemia (peds)|Hypoglycemia]]<br />
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{{Syncope causes}}<br />
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==Evaluation==<br />
*Consider if [[BRUE]] or [[seizure (peds)|seizure]] workup warranted<br />
*[[Pediatric EKG|EKG]]<br />
**Look for [[prolonged QT]] syndrome, [[dysrhythmia]], evidence of [[congenital heart disease]]<br />
**Some evidence of increased QT dispersion in children with breath holding spells<ref>Movahedian AH1, Heidarzadeh Arani M2, Motaharizad D3, Mousavi GA4, Mosayebi Z5. Evaluation of QT Dispersion in Children with Breath Holding Spells. Iran J Child Neurol. 2016 Winter;10(1):25-30. PMID: 27057184</ref><br />
*Consider CBC to screen for anemia if poor access to primary care<br />
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==Management==<br />
*No specific treatment<br />
*Reassurance- benign phenomena that does not typically result in injury and will resolve with time<br />
*Do ''not'' need cardiology or neurology outpatient referrals<ref>Yilmaz U1, Doksoz O2, Celik T3, Akinci G4, Mese T5, Sevim Yilmaz T6. The value of neurologic and cardiologic assessment in breath holding spells. Pak J Med Sci. 2014 Jan;30(1):59-64. PMID: 24639832</ref><br />
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==Disposition==<br />
*Discharge<br />
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==See Also==<br />
*[[Syncope (peds)]]<br />
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==External Links==<br />
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==References==<br />
<references/><br />
[[Category:Pediatrics]]</div>ClaireLewis