Please forward this error screen to sharedip-10718044127. They are hampton ecg pdf free download common in children between 6 and 18 months and usually not present after 5 years of age.
They are unusual before 6 months of age. They may be confused with a seizure disorder. They are sometimes observed in response to frustration during disciplinary conflict. There are four types of breath-holding spells. The most common is termed simple breath-holding spell, in which the manifestation is the holding of breath in and expiration.
The usual precipitating event is a frustration or injury leading to the temporary cessation of breathing in and expiration. There is no major alteration of circulation or oxygenation and the recovery is spontaneous. The second type are the Cyanotic breath-holding spells. They are usually precipitated by anger or frustration although they may occur after a painful experience.
The child usually recovers within a minute or two, but some fall asleep for an hour or so. In the third type, known as Pallid breath-holding spells, the most common stimulus is a painful event. The EEG is also normal, and again there is no postictal phase, nor incontinence. The child is usually alert within a minute or so. A fourth type, known as Complicated breath-holding spells, may simply be a more severe form of the two most common types. This type generally begins as either a cyanotic or pallid spell that then is associated with seizure like activity. An EEG taken while the child is not having a spell is still generally normal.
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. There is no definitive treatment available or needed for breath-holding spells, as the child will eventually outgrow them. Some trials have demonstrated the efficacy of iron therapy, especially because although BHS can readily occur without anemia, BHS has been found to be exaggerated by the presence of anemia.