June 29, 1970

Breathholding Spells in Children Differentiation From Epileptic Attacks

Author Affiliations

From the Department of Pediatrics, The Johns Hopkins University School of Medicine and the Epilepsy Clinic of The Johns Hopkins Hospital, Baltimore.

JAMA. 1970;212(13):2231-2235. doi:10.1001/jama.1970.03170260027005

Severe breathholding spells in children follow a more or less constant clinical pattern, and the electroencephalogram is almost always normal. The spells generally appear during the first two years of life, but rarely before 6 months of age. They usually disappear spontaneously after 4 years of age and rarely recur after age 6 years. Breathholding episodes are observed almost exclusively in children with normal intelligence and do not cause demonstrable evidence of brain damage. However, they are frequently associated with or followed by behavioral disturbances. The familial incidence is high. Breathholding attacks are essentially innocuous and the general outlook is excellent. The associated unconsciousness and convulsions are very short and benign, and require no immediate care. The administration of antiepileptic or tranquilizing drugs or both is of no value. Treatment consists primarily of parent-child guidance and reassurance.