pediatrics
Breath Holding Spells
Introduction
A breath-holding spell is an episode in which the child stops breathing involuntarily and loses consciousness for a short period immediately after a frightening or emotionally upsetting event or after a painful experience. (See also Overview of Behavioral Problems in Children .) Breath-holding spells occur in 0.1% to 5% of otherwise healthy children ( Reference ). They usually begin in the first year of life and peak at age 2. They disappear by age 4 in 50% of children and by age 8 in about 83% of children. The remainder may continue to have spells into adulthood. Breath-holding spells do not appear to be risk factors for true epilepsy but may be associated with an increased risk of fainting spells in adulthood. There are 2 forms of breath-holding spells: This form is the most common and often occurs as part of a Temper Tantrums or in response to a scolding or other upsetting event. Pallid form:This form typically follows a painful experience, such as falling and banging the head but can follow frightening or startling events. Both forms are involuntary and readily distinguished from uncommon, brief periods of voluntary breath-holding by children who invariably resume normal breathing after getting what they want or after becoming uncomfortable when they fail to get what they want. 