Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt

Authors

  • Abdelrahim Abdrabou Sadek Assistant professor and head of Pediatric Neurology Unit, Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egyp

Keywords:

breath holding spells, cyanotic spells, pallid spells, iron deficiency anemia

Abstract

Introduction: Breath-holding spells (BHSs) are involuntary pauses of breathing, sometimes accompanied by loss of consciousness. They usually occur in response to an upsetting or surprising situation.  Breath-holding spells are usually caused by either a change in the usual breathing pattern or a slowing of the heart rate. In some children, BHSs may be related to iron deficiency anemia. The aim of the work was to study the clinical and laboratory profile of BPHs in children presented to the Neuropediatric Clinic at Sohag University Hospital. 

Methods: An observational prospective study was done at Sohag University Hospital over a period of one year on children diagnosed as having BHSs by clinical history and laboratory evaluation, including complete blood count (CBC), serum iron, serum ferritin, total iron binding capacity, and Electroencephalography (EEG). 

Results: During the period of study (one year), we reviewed data of 32 children who had been diagnosed as having BHSs. We found that cyanotic spells (71.88%) predominated over pallid spells. There were positive family histories (31.25%) and consanguinity (53.135) in the studied patients. We found a high incidence of iron deficiency anemia (62.5%) in association with BHS. Abnormal EEGs were found in (65.63%) of studied children. 

Conclusion: BHS is a common, important problem associated with iron deficiency anemia, which is, in turn, a common nutritional problem in our country.

References

DiMario FJ Jr. Prospective Study of Children with Cyanotic and Pallid Breath-Holding Spells. Pediatrics.

; 107(2): 265-9. PMID: 11158456.

Anderson JE, Bluestone D. Breath-Holding Spells: Scary but not Serious. Contemp Pediatr. 2000; 1: 61.

Health wise. Breath holding spells, Incorporated, Boise, 2010; ID 83701.

Hudagolu O, Dirik E, Yis U. Parental attitude of mothers, iron deficiency anemia, and breath-holding

spells. Pediatr Neurol. 2006; 35: 18–20. doi: 10.1016/j.pediatrneurol.2005.12.006. PMID: 16814080.

Orri KE, Kato Z, Osamu F. Changes of autonomic nervous system function in patients with breath holding

spells treated with iron. J Child Neurology. 2002; 17: 337-40. doi: 10.1177/088307380201700505.

Abbaskhanian A, Ehteshami S, Sajjadi S, Rezai MS. Effects of Piracetam on Pediatric Breath Holding

Spells: A Randomized Double Blind Controlled Trial. Iran J Child Neurol. 2012; 6: 9-15. PMID:

, PMCID: PMC3943019.

Ashrafi MR, Shajari H, Salajegheh N. Breath-holding spells: an analysis of 43 cases. Iran J Child Neurol.

; 2: 17–20.

Handan Gençgonül, Şükrü Cin, Nejat Akar, Gülhis Deda. Iron and zinc levels in breath holding spells.

journal of Ankara medical school. 2002; 24: 56-96.

Olsen AL, Mathiasen R, Rasmussen NH, Knudsen FU. Long-term prognosis for children with breath- holding spells. Dan Med Bull. 2010; 57(11): A4217. PMID: 21055373.

Tonekaboni SH, Alavi S, Mahvelati F, Tabasi Z. Effects of oral iron supplement on breath- holding spells

in children. Iran J Child Neurol. 2006; 1: 33-7.

Subbarayan A, Ganesan B, Anbumani J. Temperamental traits of breath holding children: a case control

study. Indian J Psychiatry. 2008; 50: 192–6. doi: 10.4103/0019-5545.43635. PMID: 19742234, PMCID:

PMC2738355.

Bhat MA, Ali W, Mohidin K, Sultana M. Prospective study of severe breath holding spells and role of iron.

India Journal of Pediatric Neurology. 2007; 5: 27–32.

Anil BG, Nedunchezian K, Jayanthini V, Pathmanabhan M. Breath Holding Spells: Evaluation of

Autonomic Nervous System Function. Indian Pediatrics. 2005; 42: 923-7. PMID: 16208053.

Paul S, Matz MD. Breath-Holding Spells is a sample topic found in Pediatrics Central. Last updated 2009:

October 26.

Bhatia MS, Singhal PK, Dhar NK, Nigam VR, Malik SC, Mullick DN. Breath-holding spells: an analysis

of 50 cases. Indian Journal Pediatric. 1990; 27; 73–9.

Zehetner AA, Orr N, Buckmaster A, Williams K, Wheeler DM. Iron supplementation for breath-holding

attacks in children. Cochrane Database Syst Rev. 2010; 5: 1578–605. doi:

1002/14651858.cd008132.pub2. PMID: 20464763.

Goraya JS, Virdi VS. Persistence of breath holding spells into late childhood. J Child Neurol. 2001; 16:

-8. doi: 10.1177/088307380101600916. PMID: 11575615.

Daoud AS, Batieha A, Al-Sheyyab M, Ebuekteish F, Hijazi S. Effectiveness of iron therapy on breath- holding spells. J Pediatr. 1997; 130: 547–50. doi: 10.1016/S0022-3476(97)70237-3. PMID: 9108851.

Evans Owen B. Breath holding spells. Pediatric Annals. 1997; 26: 7. doi: 10.3928/0090-4481-19970701- 05.

Hilal Mocan, Alisan Yildiran, Fazil Orhan, Erol Erduran. Breath holding spells in 91 children and response

to treatment with iron. Arch Dis Child. 1999; 81: 261–2. doi: 10.1136/adc.81.3.261. PMID: 10451402,

PMCID: PMC1718051.

Published

2022-03-07

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