Breath-Holding Spells in Childhood

DiMario, Francis J.

doi:10.1001/archpedi.1992.02160130127035

Cited by 44 publications

(47 citation statements)

References 25 publications

(4 reference statements)

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“…There is strong evidence that autonomic nervous system dysfunction in the form of high resting heart rate and diastolic blood pressure is associated with BHS [2,6].…”

Section: Introductionmentioning

confidence: 99%

Double-blind, placebo-controlled trial on the effect of piracetam on breath-holding spells

Sawires

Botrous

2012

Eur J Pediatr

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Breath-holding spells (BHS) are apparently frightening events occurring in otherwise healthy children.The aim of this study was to evaluate the efficacy of piracetam in the treatment of breath-holding spells. Forty patients with BHS (who were classified into two groups)were involved in a double-blinded placebo-controlled prospective study. Piracetam was given to group A while group B received placebo. Patients were followed monthly for a total period of 4 months. The numbers of attacks/month before and monthly after treatment were documented, and the overall number of attacks/month after treatment was calculated in both groups. The median number of attacks/month before treatment in the two groups was 5.5 and 5,respectively, while after the first month of treatment, it was 2 and 5, respectively. The median overall number of attacks/month after treatment in both groups was 1 and 5, respectively.There was a significant decline of number of attacks after piracetam treatment compared to placebo (p value<0.001). There were no reported side effects of the piracetam throughout the study period. In conclusion, piracetam is a safe and effective drug for the treatment of breath-holding spells in children.

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“…There is strong evidence that autonomic nervous system dysfunction in the form of high resting heart rate and diastolic blood pressure is associated with BHS [2,6].…”

Section: Introductionmentioning

confidence: 99%

Double-blind, placebo-controlled trial on the effect of piracetam on breath-holding spells

Sawires

Botrous

2012

Eur J Pediatr

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“…DiMario noted that the term is a misnomer that implies a voluntary action resulting in a prolonged inspiration, whereas in actuality the spells are involuntary, reflexive, and occur during expiration [39]. The presence of an underlying dysfunctional autonomic nervous system in children with BHS has been proposed by some workers [39,40], whereas others have reported their association with iron deficiency anemia. Holowach et al demonstrated that children with severe BHS had significantly lower haemoglobin values than children in a control group.…”

Section: Ida and Breath Holding Spellsmentioning

confidence: 99%

Iron Deficiency: Beyond Anemia

Yadav

Chandra

2010

Indian J Pediatr

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Iron deficiency is the most common nutritional disorder affecting at least one third of world's population. Though anemia is common manifestation of iron deficiency, other effects of iron deficiency on various tissues, organs and systems are usually under recognized. Impaired brain development and cognitive, behavioural and psychomotor impairment are most worrisome manifestations of iron deficiency. Studies have demonstrated that some of these changes occurring during period of brain growth spurt (<2 years age) may be irreversible. Association of iron deficiency with febrile seizures, pica, breath holding spells, restless leg syndrome and thrombosis is increasingly being recognized. Impaired cell-mediated immunity and bactericidal function are generally noted in iron-deficient persons; however, the findings are inconsistent. Despite proven reversible functional immunological defects in vitro studies, a clinically important relationship between states of iron deficiency and susceptibility to infections remains controversial. Studies from malaria endemic regions have reported increased incidence of malaria in association with iron supplementation. These and some other aspects of iron deficiency are reviewed in this article.

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Section: A Positive Correlation Was Detected Between Serum Soluble Trmentioning

confidence: 99%

“…Holowach and Thurston speculated that having an anemia in children who suffered from severe breath-holding spells might have predisposed these children to loss of consciousness. They reported that different degrees of the anemia were detected in patients with breath-holding spells [1][2][3][4][5][6][7][8].…”

Section: A Positive Correlation Was Detected Between Serum Soluble Trmentioning

confidence: 99%

“…They are also called syncopal attacks and consist of episodes of apnea, unconsciousness, and changes in postural tonus. They occur most commonly within the first 12 months of life and virtually all breath-holders experience their initial spell by the age of 2 years [1][2][3].Previous studies revealed that autonomic nervous system dysregulation was emphasized as the pathophysiologic mechanism. Further, breath-holding spells have also been shown to be associated with iron-deficiency anemia.…”

mentioning

confidence: 99%

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Serum Soluble Transferrin Receptor Is a Valuable Diagnostic Tool in Iron Deficiency of Breath-Holding Spells

Uǧur

Cin

Deda

et al. 2005

Pediatric Hematology and Oncology

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Iron-deficiency anemia may be a factor contributing to breath-holding spells. The serum transferrin receptor provides a useful measure of tissue iron deficiency. In this study of 50 breath-holders, while iron-deficiency anemia was detected in 28 (56%) of patients with routine tests, serum transferrin receptor levels were found increased in all patients. A positive correlation was detected between serum soluble transferrin receptor levels and frequency of attacks. It is suggested that the serum transferrin receptor level is useful as a single test for identification of iron deficiency in breath-holders. Moreover, if iron deficiency can be diagnosed earlier, then patients can be treated earlier.

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Breath-Holding Spells in Childhood

Cited by 44 publications

References 25 publications

Double-blind, placebo-controlled trial on the effect of piracetam on breath-holding spells

Double-blind, placebo-controlled trial on the effect of piracetam on breath-holding spells

Iron Deficiency: Beyond Anemia

Serum Soluble Transferrin Receptor Is a Valuable Diagnostic Tool in Iron Deficiency of Breath-Holding Spells

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