In the outpatient clinic, I often encounter parents who find that their children have "convulsions" after crying, and parents are very worried that their children have epilepsy, and through **seizures** or parents' careful description, in the end, most of the children are not epilepsy, but children's breath-holding seizures. This is a relatively common condition in children, especially during times of emotion, such as crying, anger or frustration, sudden painful stimuli, the child may suddenly experience apnea, purple lips, loss of consciousness, and even tics.
**Breath-holding spells, medically known as breath-holding spells, are a central autonomic neuromodulation disorder that may be genetic. About 5% of babies will have this condition, and 20 to 30 percent of these parents who have children with breath-holding episodes may have had a similar history as a child. Breath-holding seizures are divided into cyanotic and pallor syncope, with the cyanotic form being more common and about three times more common than the pale form. Most children exhibit only one type, but 20% may exhibit both.
Cyanogenic syncope is usually induced by emotional agitation such as anger or fear, almost always when the crying is intense, the crying is the most severe, the breathing suddenly stops in the expiratory phase, the voice stops, the lips gradually turn blue, the limbs are soft, the shouting should not be, the body may twitch in the later stage, and then gradually regain consciousness to breathe or fall asleep, and there are also in the early stage of sudden anger before the time to cry.
The pallor syncope is usually caused by sudden painful events such as head impact, fall, etc., which is relatively rare, often after a sudden fall or painful stimulation, the face is pale, the body is paralyzed and falls to the ground, consciousness is gradually unclear, breathing and heartbeat stop, shouting should not be, and there may be body tics in the later stage, which is often misdiagnosed as a seizure. For the doctor, the most important differentiation is to carefully ask about the onset of each seizure, whether each seizure has a painful stimulus trigger, seizures usually have a sudden seizure without any trigger, of course, if the EEG catches the seizure, it is the gold standard for identification, but the actual situation is that the EEG can rarely catch the seizure, and it depends more on the doctor's careful medical history and clinical experience.
It is important for parents to understand that although these seizures look scary, especially the physical "convulsions" in the later stages of the seizures, which often make witnesses feel that the child may die and are very nervous, in fact, the physical "convulsions" in the later stages of the seizures are caused by the loss of control of the lower center (brainstem) after the cerebral ischemia and hypoxia after the cardiac respiratory arrest, which is caused by the instructions issued by the brainstem, which is a release symptom of the brainstem, and is not a seizure caused by abnormal electrical discharges in the cerebral cortex. This has been confirmed by an electroencephalogram (EEG): during an attack, the child's electroencephalogram (EEG) usually shows flattened amplitude and no epileptiform activity.
Breath-holding episodes usually don't cause long-term harm to your child. After an attack, the child usually returns to normal very quickly. However, since these seizures are often mistaken for epilepsy, proper diagnosis and interpretation are crucial to alleviate the anxiety of parents and the development of a plan for the child's next steps.
During the diagnosis, the doctor will ask about the cause of the seizure, the condition of the respiratory arrest, the child's complexion changes, and family history, so that witnesses can describe the cause and process of the seizure in detail, and it is very important to photograph the seizure so that the doctor can make the diagnosis.
*In terms of this, it has been reported that drugs such as piracetam or levetiracetam can reduce the frequency of seizures, but the vast majority of children do not need to take medication**, they only need to reduce the aforementioned trigger stimuli, and when the child is crying, coax not to cry too violently in time, it can also reduce the frequency of seizures, and most children disappear before the age of 4, and all cases will disappear before the age of 8.
As a clinician, it is more important for parents to understand the nature of these seizures, to know that they are harmless, that the child does not die during the seizure, that there has never been a case of death due to a breath-holding seizure, and that the child will eventually stop relieving on its own with each seizure, which is very important to alleviate parents' worries about the future.
When dealing with breath-holding episodes, parents should remain calm and avoid placing their child in an upright position, as this may reduce blood flow to the brain** and cause the seizure to last longer. On the contrary, the child's head should be relied on, and the child should be kept in a flat lying position, so that the brain can restore blood and oxygen supply in time, so as to shorten the duration of the attack.
Keep in mind that breath-holding episodes, while worrisome, are usually self-limiting, and as the child gets older, the seizures gradually decrease or even disappear. If your child is experiencing similar symptoms, it is advisable to take a good picture of the seizure**, carefully think about the possible triggers and seizures before each seizure, and see a neurologist in time for a correct diagnosis and guidance.
Popular science little gods.