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

Year 2021, , 165 - 172, 29.05.2021

Fatma Hancı , Sevim Türay , Ömer Faruk Tırınk , Nimet Kabakuş

https://doi.org/10.21673/anadoluklin.797238

Abstract

Aim: In this study, we aimed to investigate the etiological factors, electroencephalographic (EEG) findings, rates of response to iron therapy, and factors affecting response to iron therapy in children diagnosed with breath-holding spells (BHS).

Methods: The study included 136 children aged 1 to 48 months who received iron therapy after a BHS diagnosis at our pediatric neurology clinic between November 2015 and No¬vember 2019. Patient medical records (physical examination, laboratory and EEG findings, medical history, and effectiveness of iron therapy) were reviewed retrospectively.

Results: Of all patents, 81 (59.6%) exhibited partial response (partial remission) to iron therapy (50% decrease in BHS frequency), 52 (39%) responded completely (complete remission), and 2 were unresponsive. Comparison of the patients with complete and partial remission revealed a higher rate of complete remission in girls. In addition, patients with complete remission had higher levels of hemoglobin, MCV, and ferritin than those with partial remission. Complete remission rates were also higher in patients with normal EEG findings.

Conclusion: BHS in childhood is a benign, recurring, and non-epileptic disorder and its differentiation from epilepsy is important. Children with BHS respond well to iron therapy, which can be recommended even if the serum iron and ferritin levels are normal.

Keywords

breath holding spells, iron supplementation, electroencephalography

Katılma Nöbetleri: Etiyolojik Faktörler, Laboratuvar Bulguları ve Demir Tedavisine Yanıt Oranları

Abstract

Amaç: Bu çalışmada katılma nöbetlerinin etiyolojik faktörlerini, elektroensefalografi (EEG) bulgularını, demir tedavisne cevap oranlarını ve demir tedavisine cevabı etkileyen faktörleri araştırmayı amaçladık.

Yöntem: Kasım 2015-Kasım 2019 yılları arasında çocuk nöroloji kliniğimizde katılma nöbeti tanısı alan hastaların tıbbi öykülerini, fizik muayenelerini, laboratuar ve EEG bulgularını ve demir tedavisinin etkinliğini retrospektif olarak değerlendirdik.

Bulgular: 1-48 ay arası katılma nöbeti tanısı koyduğumuz ve demir tedavisi alan 136 hastayı çalışmaya aldık. 81 hasta (% 59.6) demir tedavisine kısmi yanıt (katılma nöbetlerinin sıklığında 50% azalma), 52 hasta ise (% 39) tam cevap verdi. İki hasta demir tedavisine cevapsızdı.
Demir tedavisine kısmi yanıt verenlerle tam yanıt veren hastalar karşılaştırıldığında kızlarda tam yanıt verme oranı daha yüksekti. Ayrıca tam yanıt veren hastaların hemoglobin, MCV ve ferritin düzeyleri kısmi yanıt verenlere göre daha yüksekti. Aynı zamanda EEG bulguları normal olan hastalarda tam yanıt verme oranları daha yüksekti.

Sonuç: Katılma nöbetleri iyi huylu, tekrarlayan çocukluk çağının epileptik olmayan bozukluklarındandır ve epilepsiden ayırt edilmesi önemlidir. Demir tedavisine iyi yanıt verirler ve serum demiri ve ferritin düzeyi normal olsa bile bu tedavinin verilmesi önerilebilir.

Keywords

katılma nöbetleri, demir desteği, elektroensefalografi

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