Breath holding spell

Definition:

Holding the breath to the point of semiconsciousness or unconsciousness.

Causes, incidence, and risk factors:

Breath holding is seen in some normal children approximately 8 months to 2 years of age. It appears to be a reflexive response to fear, a traumatic event (pain), or to being startled. The child may make a short gasp and then exhale and cease breathing. Then the child rapidly becomes bluish (cyanotic) and may have several jerky movements resembling a small seizure. The event is terminated by a momentary period of semiconsciousness or unconsciousness, at which time normal breathing resumes. The color improves with the first breath and the event is over. This behavior may be repeated several times per day or seen only on rare occasions.

Breath holding can be a frightening event for parents who may perceive it as a seizure or even cardiac arrest. Breath holding can be mistaken as a seizure and seizures can be mistaken as breath holding. A physician evaluation to determine that the behavior is, indeed, breath holding is appropriate. Breath holding may also be a symptom of a rare genetic disorder, Riley-Day syndrome.

After recognizing the event as breath holding, the parent can simply await the event's natural conclusion. Afterward, no undue attention should be given the child, which might encourage a repetition of the behavior with future events.