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Çocuklarda Nefes Tutma Atakları

Year 2016, Volume: 10 Issue: 1, 70 - 76, 01.04.2016

Abstract

Nefes tutma atakları erken çocukluk çağında yaygın görülen epileptik olmayan tekrarlayıcı olaylardandır. Bu ataklar bazı emosyonel uyaranlarla tetiklenen kısa apne epizotlarından oluşmaktadır. Nefes tutma atakları genellikle altı ile 18 aylar arasındaki çocuklarda başlar. Nefes tutma atakları siyanotik ve pallid (soluk) tip olmak üzere ikiye ayrılır. Bu iki tipin ortaya çıkış mekanizmaları farklıdır. Siyanotik tipte yoğun solunum inibisyonu ile beraber hafif kardiyak etki var iken, pallid tipte güçlü kardiyak inhibisyon ile beraber hafif solunumsal etki vardır. Nefes tutma ataklarının tanısı büyük ölçüde karakteristik anamnez ve klinik bulgulara dayanır. Ayırıcı tanıda epilepsi ve kardiyolojik hastalıklar düşünülmelidir.Ayırıcı tanı için EKG kaydı ve video EEG izlemi çok az hastada gerekebilir.Nefes tutma atakları olan çocuklarda herhangi bir antiepileptik tedavi gerekmez ve prognoz mükemmeldir.

References

  • Di Mario FJ Jr. Paroxysmal nonepileptic events of childhood. Semin Pediatr Neurol 2006;13:208-21.
  • Aicardi J. Paroxysmal disorders other than epilepsy. In: Aicardi J, Bax M, Gillberg C (eds). Diseases of the Nervous system in Childhood. 3rd ed. London: Mac Keith Press, 2009:666-95.
  • Iyer A, Appleton R. Management of refl ex anoxic seizures in children. Arch Dis Child 2013;98:714-7.
  • Breningstall GN. Breath-holding spells. Pediatr Neurol 1996;14: 91-7.
  • DiMario FJ Jr. Breath-holding spells in childhood. Am J Dis Child 1992;146:125-31.
  • Livingston S. Breathholding spells in children differentiation from epileptic attacks. JAMA 1970;212:2231-5.
  • Lombroso CT, Lerman P. Breath holding spells (cyanotic and pallid infantile syncope). Pediatrics 1967;39:563-81.
  • Carman KB, Ekici A, Yimenicioglu S, Arslantas D, Yakut A. Breath holding spells: Point prevalence and associated factors among Turkish children. Pediatr Int 2013;55:328-31.
  • Azam M, Bhatti N, Shahab N. Piracetam in severe breath holding spells. Int J Psychiatry Med 2008;38:195-201.
  • Onslow JM, Burden J. Anaesthetic considerations for a child with refl ex anoxic seizures. Paediatr Anaesth 2003;13:552-3.
  • Carano N, Bo I, Zanetti E, Tchana B, Barbato G, Agnetti A. Glycopyrrolate and theophylline for the treatment of severe pallid breath-holding spells. Pediatrics 2013;131:1280-3.
  • Sakaue S, Chiyonobu T, Moroto M, Morita T, Yoshida M, Morioka S, et al. A case with recurrent asystole due to breath-holding spells: Successful treatment with levetiracetam. No To Hattatsu 2012;44:496-8.
  • Çalık M, Oğuz E, Sarıkaya S, Kandemir H,Yoldaş TH. Melatonin can be used to treat childhood breth holding spells. J Child Neurol 2015;30:1089.
  • Kelly AM, Porter CJ, McGoon MD, Espinosa RE, Osborn MJ, Hayes DL. Breath-holding spells associated with signifi cant bradycardia: Successful treatment with permanent pacemaker implantation. Pediatrics 2001;108:698-702.
  • Sartori S, Nosadini M, Leoni L, de Palma L, Toldo I, Milanesi O, et al. Pacemaker in complicated and refractory breath-holding spells: When to think about it? Brain Dev 2015;37:2-12.
  • Taiwo B, Hamilton AH. Cardiac arrest: a rare complication of pallid syncope? Postgrad Med J 1993;69:738-9.
  • Paulson G. Breath holding spells: A fatal case. Dev Med Child Neurol 1963;5:246-51.
  • Olsen AL, Mathiasen R, Rasmussen NH, Knudsen FU. Long-term prognosis for children with breath-holding spells. Dan Med Bull 2010;57:A4217.

Breath-Holding Spells in Children

Year 2016, Volume: 10 Issue: 1, 70 - 76, 01.04.2016

Abstract

Breath-holding spells are common nonepileptic paroxysmal events in early childhood. They consist of brief apneic episodes provoked by some acute emotional stimulus. Breath-holding spells usually begin at the age of 6-18 months. Breath-holding spells are classifi ed into cyanotic and pallid types. The pathogenetic mechanisms of the two types are different. While there is intense respiratory inhibition with slight cardiac effect in the cyanotic type, there is powerful cardiac inhibition with slight respiratory effect in the pallid type. The diagnosis of breath-holding spells is largely based on the characteristic history and clinical events. Epilepsy and cardiac disease should be considered in the differential diagnosis. A few patients may require ECG recording and video EEG monitoring in the differential diagnosis. Antiepileptic treatment is not required in children with Breath-holding spells, and the prognosis is excellent

References

  • Di Mario FJ Jr. Paroxysmal nonepileptic events of childhood. Semin Pediatr Neurol 2006;13:208-21.
  • Aicardi J. Paroxysmal disorders other than epilepsy. In: Aicardi J, Bax M, Gillberg C (eds). Diseases of the Nervous system in Childhood. 3rd ed. London: Mac Keith Press, 2009:666-95.
  • Iyer A, Appleton R. Management of refl ex anoxic seizures in children. Arch Dis Child 2013;98:714-7.
  • Breningstall GN. Breath-holding spells. Pediatr Neurol 1996;14: 91-7.
  • DiMario FJ Jr. Breath-holding spells in childhood. Am J Dis Child 1992;146:125-31.
  • Livingston S. Breathholding spells in children differentiation from epileptic attacks. JAMA 1970;212:2231-5.
  • Lombroso CT, Lerman P. Breath holding spells (cyanotic and pallid infantile syncope). Pediatrics 1967;39:563-81.
  • Carman KB, Ekici A, Yimenicioglu S, Arslantas D, Yakut A. Breath holding spells: Point prevalence and associated factors among Turkish children. Pediatr Int 2013;55:328-31.
  • Azam M, Bhatti N, Shahab N. Piracetam in severe breath holding spells. Int J Psychiatry Med 2008;38:195-201.
  • Onslow JM, Burden J. Anaesthetic considerations for a child with refl ex anoxic seizures. Paediatr Anaesth 2003;13:552-3.
  • Carano N, Bo I, Zanetti E, Tchana B, Barbato G, Agnetti A. Glycopyrrolate and theophylline for the treatment of severe pallid breath-holding spells. Pediatrics 2013;131:1280-3.
  • Sakaue S, Chiyonobu T, Moroto M, Morita T, Yoshida M, Morioka S, et al. A case with recurrent asystole due to breath-holding spells: Successful treatment with levetiracetam. No To Hattatsu 2012;44:496-8.
  • Çalık M, Oğuz E, Sarıkaya S, Kandemir H,Yoldaş TH. Melatonin can be used to treat childhood breth holding spells. J Child Neurol 2015;30:1089.
  • Kelly AM, Porter CJ, McGoon MD, Espinosa RE, Osborn MJ, Hayes DL. Breath-holding spells associated with signifi cant bradycardia: Successful treatment with permanent pacemaker implantation. Pediatrics 2001;108:698-702.
  • Sartori S, Nosadini M, Leoni L, de Palma L, Toldo I, Milanesi O, et al. Pacemaker in complicated and refractory breath-holding spells: When to think about it? Brain Dev 2015;37:2-12.
  • Taiwo B, Hamilton AH. Cardiac arrest: a rare complication of pallid syncope? Postgrad Med J 1993;69:738-9.
  • Paulson G. Breath holding spells: A fatal case. Dev Med Child Neurol 1963;5:246-51.
  • Olsen AL, Mathiasen R, Rasmussen NH, Knudsen FU. Long-term prognosis for children with breath-holding spells. Dan Med Bull 2010;57:A4217.
There are 18 citations in total.

Details

Other ID JA97GF44KE
Journal Section Collection
Authors

Ayşe Kaçar Bayram This is me

Hüseyin Per This is me

Publication Date April 1, 2016
Submission Date April 1, 2016
Published in Issue Year 2016 Volume: 10 Issue: 1

Cite

Vancouver Bayram AK, Per H. Breath-Holding Spells in Children. Türkiye Çocuk Hast Derg. 2016;10(1):70-6.


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