Iron supplementation should be given in breath-holding spells regardless of anemia

Abstract

Background/aim: The purpose of this retrospective study was to determine the effectiveness of oral iron therapy in breath-holding spells and evaluation of electrocardiographical changes. Materials and methods: Three hundred twelve children aged 1-48 months and diagnosed with breath-holding spells between January 2017 and April 2018 were included. Patients' laboratory findings were compared with 100 patients who had one simple febrile seizure. Results: Cyanotic breath-holding spells were diagnosed in 85.3% (n = 266) of patients, pallid spells in 5.1% (n = 16), and mixed-type spells in 9.6% (n = 30). Sleep electroencephalograms were applied for all patients, 98.2% (n = 306) of which were normal, while slow background rhythm was determined in 1.2% (n = 4). Epileptic activity was observed in only 2 patients (0.6%). The mean hemoglobin (Hb) value in the breathholding spell group was 10.1 mg/dL. Patients' mean corpuscular volume (MCV) was 73 fL. Patients' Hb and MCV values were statistically significantly lower than those of the control group (P < 0.001). The difference between spell burden was not statistically significant (P = 0.691). Spell burden decreased equally in both groups. Conclusion: Oral iron therapy can be administered in breath-holding seizures irrespective of whether or not the patient is anemic.

Breath-holding Spells: Etiological Factors, Laboratory Findings, and Rates of Response to Iron Therapy

“…The reported mean age of onset is generally 6-12 months (2,8,9). The reported incidence of a family history of epilepsy has ranged from 7.7 to 29% (10,13,14). In consistence with the previous literature, the same figure was determined to be 19.1% in our study.…”

“…Data on the genetic predisposition or family history of BHS may vary between countries. Studies from Turkey have reported similar figures (10,11).…”

“…We observed that our sample included more girls than boys, and rates of complete remission with iron therapy were also higher in girls. Previous studies have reported a male predominance (8) or no significant sex difference (2,3,10,11). The female predominance in the present study may be due to the sample selection.…”

“…One study reported rates of higher complete and partial remission with iron therapy in patients with low mean Hb levels (23). In another study, all patients, with or without IDA, received iron therapy (4 mg/kg/ day) and the treatment responses in anemic and nonanemic patients revealed a decreased spell burden and attack duration in both groups, although neither finding was statistically significant (10). In another study, frequency of spells at diagnosis and intolerance to oral iron were significantly associated with poor response to iron supplementation.…”

Effectiveness Oral Theophylline, Piracetam, and Iron Treatments in Children With Simple Breath-Holding Spells

“…Our results were in good agreement with other studies. 17,[23][24][25] Abbreviations: Hb, hemoglobin; Hct, hematocrit; MCV, mean corpuscular volume; TIBC, total iron-binding capacity. *P < .001 when compared to the nontreated group.…”