children s health issues
Breath Holding Spells
Introduction
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. Tantrums, often a component of breath-holding spells, may be prevented by distracting the child and avoiding situations known to trigger the spells. Breath-holding spells occur in less than 1% to about 5% of otherwise healthy children. 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. A small percentage of these children may continue to have spells into adulthood. Breath-holding spells can take one of two forms: Cyanotic (blue) Pallid (pale) 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. Involuntary breath-holding spells are easily distinguished from uncommon, brief episodes of voluntary breath-holding by some children. Children who voluntarily hold their breath do not lose consciousness and go back to breathing normally after they get what they want or after becoming uncomfortable when they do not get what they want. (See also Overview of Behavioral Problems in Children .) 