Ver el código de «Breath-holding spell»

==Background==
*Episode during which child holds breath, usually during excessive crying upon exhalation
*May occur after painful/scary/irritating event or after being disciplined or becoming angry
*'''Not''' intentional e.g. child is not trying to pass out<ref>Goldman RD. Breath-holding spells in infants. Can Fam Physician. 2015 Feb;61(2):149-50. PMID: 25676645</ref>
*Typically occur in children 6-18mo but can be up to 6yo
*Occur in 5% of all children<ref>https://pedemmorsels.com/breath-holding-spell/</ref>

==Clinical Features==
*Breath-holding during crying or intense emotion
*May be associated with:
**[[Syncope (peds)|Syncope]]
***LOC brief, spontaneously resolves
***May have brief [[seizure (peds)|seizure]]-like activity, but NO postictal period
**Cyanosis
**Pallor

==Differential Diagnosis==
*[[Seizure]]
*Toxicological (stimulants or depressant)
*[[CO poisoning ]]
*[[Breath-holding spell]]
*[[Tet spell]]
*[[congenital heart disease|Cardiac disease]]
*Pregnancy (especially ectopic)
*[[Hypoglycemia (peds)|Hypoglycemia]]

{{Syncope causes}}

==Evaluation==
*Consider if [[BRUE]] or [[seizure (peds)|seizure]] workup warranted
*[[Pediatric EKG|EKG]]
**Look for [[prolonged QT]] syndrome, [[dysrhythmia]], evidence of [[congenital heart disease]]
**Some evidence of increased QT dispersion in children with breath holding spells<ref>Movahedian AH1, Heidarzadeh Arani M2, Motaharizad D3, Mousavi GA4, Mosayebi Z5. Evaluation of QT Dispersion in Children with Breath Holding Spells. Iran J Child Neurol. 2016 Winter;10(1):25-30. PMID: 27057184</ref>
*Consider CBC to screen for anemia if poor access to primary care

==Management==
*No specific treatment
*Reassurance- benign phenomena that does not typically result in injury and will resolve with time
*Do ''not'' need cardiology or neurology outpatient referrals<ref>Yilmaz U1, Doksoz O2, Celik T3, Akinci G4, Mese T5, Sevim Yilmaz T6. The value of neurologic and cardiologic assessment in breath holding spells. Pak J Med Sci. 2014 Jan;30(1):59-64. PMID: 24639832</ref>

==Disposition==
*Discharge

==See Also==
*[[Syncope (peds)]]

==External Links==


==References==
<references/>
[[Category:Pediatrics]]