BREATH-HOLDING spells are defined as a temporary interruption of respiration at the end of the expiratory phase, leading to mild cyanosis, unconsciousness, or convulsive seizures of either a tonic or clonic nature. In their developmental sequence there is at first crying, then a long, sustained expiratory cry without a succeeding inspiration; cyanosis replaces the previous flushing of the face (although sometimes pallor is more marked than cyanosis); then there is a stiffening of the limbs, usually in extension, followed by loss of consciousness, relaxation, inspiration, and, in a short time, recovery. In some cases, loss of consciousness is followed by generalized clonic movements of the extremities. In nearly all cases, the precipitating factor is either injury or frustration and the resulting anger, or a combination of both.
The spells are said to be an early infantile form of temper tantrum—a primitive expression of anger or frustration. Such being the case,
HINMAN A, DICKEY LB. BREATH-HOLDING SPELLS: A Review of the Literature and Eleven Additional Cases. AMA Am J Dis Child. 1956;91(1):23–33. doi:10.1001/archpedi.1956.02060020025005
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