Abstract
Introduction: Breath holding spell(BH) is an involuntary holding of the breath accompanied by loss of consciousness in response to a confrontational situation. It can be a frightening event for parents who may perceive it as a seizure or even cardiac arrest. Correlation between iron deficiency anemia and BH and improvement in BH with iron treatment have been revealed in previous studies.
Aim: Two hundred twenty patients referred to pediatric neurology department of our hospital with a diagnosis of breath holding (BH) spells were retrospectively evaluated to determine the role of anemia
Method: Clinical records were evaluated retrospectively. Gender, age of onset, type (cyanotic, pallide, mixed), severity(simple, severe), frequency of spell(<10/month, 10-30/month,>30/month) were determined. Complete blood count, electroencephalography (EEG), electrocardiography (ECG) were performed in all patients, echocardiography is performed when required. Patients who could be reached by telephone were re-evaluated.
Results: Ninety-four(42.7%)of the patients were female, 126(57.3%) were male. The mean age of onset of the spells was 12.8±10.2 months and the mean age of applying to the hospital was 23.3±16.3 months. Sixty seven(30.5%) of the patients had a family history of BH. The most common type of the spells were cyanotic (89%). 69.1% of the spells were simple. Age of onset of spells showed no significant relationship with spell severity and spell type (p>0.05). Hemoglobin values were lower in patients with accompanying convulsive behaviors when compared to simple BH(p<0.05). At follow up 107 patients could be reached, 93 of them (87%) were spell free. The spells ended in a mean of 41.5±16 months and the mean time of duration of the spells was 28.7±14.9 months. The spells ended sooner and the duration of the spells was lower in the patients whose hemoglobin and MCV levels were low at the beginning.
Conclusion: As a conclusion, our study demonstrates that anemia may be a triggering factor in some patients and treating the anemia shortens the BH spells
Keywords: breath holding spells, anemia, child
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Copyright © 2009 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.