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February 1981

Death Following Breath Holding in an Adolescent

Author Affiliations

Department of Neurology Medical College of Wisconsin PO Box 1997 Milwaukee, WI 53201 NEAL H. POLLACK, DO 2300 N. Mayfair Rd Wauwatosa, WI 53226

Am J Dis Child. 1981;135(2):180-181. doi:10.1001/archpedi.1981.02130260068021

Breath holding is not uncommon in infancy following a startle, injury, or punishment. This reaction generally does not persist beyond the age of 6 years, and the outlook for normal development is excellent.1

In 1951, Howard et al2 described voluntary breath holding in older children and adults, a practice we still find present in school-aged children.2 In this maneuver, a period of hyperventilation is followed by a Valsalva maneuver (forced expiration against a closed glottis) and the victim responds with brief unconsciousness. Howard et al warn against the risk of "injury during falling" and report the production of a convulsion in one volunteer during this procedure.

Recently, we observed a 12-year-old boy who died following a modified breath-holding spell. We report the case to document the risk involved, as well as to learn if similar incidents have been recorded by others. Report of a Case.—A 12-year-old