Affective respiratory attacks (synonym: breath-holding attacks) are episodic episodes of apnea in children, sometimes accompanied by loss of consciousness and seizures.
| ARP | |
|---|---|
| ICD-10 | R 06. |
| ICD-9 | 786.9 |
| Omim | |
ARPs are observed in approximately 5% of the population with an equal distribution between men and women. Most often occur in children aged 6 to 18 months and usually are not observed after 5 years of age. The appearance of such attacks before the age of 6 months is unusual. A positive family history can be detected in 25% of cases. They may be confused with epilepsy. ARPs usually occur in response to pain or frustration, more likely during periods of nervous tension and fatigue. The presence of seizures in children aged 6 months to 5 years does not require treatment [1] [2] and disappears without consequences with age, but requires a neuropathologist for a differential diagnosis due to the presence of similar symptoms of other more serious diseases.
Content
Classification
Very often, ARPs are divided into only 2 types - “blue” and “pale”.
There are four types of ARPs.
- The most common is called simple ARP. It manifests itself in the form of breath holding at the end of exhalation. It is usually the result of frustration or injury. There are no major changes in blood circulation or oxygenation and respiratory recovery occurs spontaneously.
- Blue type. It is usually caused by anger or frustration, although there are also from pain. The child cries and makes a forced expiration, sometimes there is cyanosis (blue color), loss of muscle tone and loss of consciousness. Most children regain consciousness, some fall asleep for an hour or two. The post-ictal phase is absent. EEG is normal.
- Pale type. The child turns pale (as opposed to the blue type) and loses consciousness; Don't cry or cry a bit. The post-ictal phase is also absent. EEG is normal.
- Complicated type. It may just be a more severe form of the previous two types. An attack of this type begins as "blue" or "pale", and then flows into a semblance of an epileptic seizure. An electroencephalogram outside the attack is basically normal.
Treatment
The most important aspect is informing family members, since an attack, in most cases, is a frightening and shocking sight, and attempts to help can lead to injuries and be ineffective without proper adult awareness.
There is no final decision on the need for treatment, since in the vast majority of cases, attacks are life-threatening, and the child, in the end, outgrows them.
See also
- Apnea
Notes
- ↑ DiMario FJ Breath-holding spells in childhood (English) // JAMA Pediatrics . - 1992 .-- January ( vol. 146 , no. 1 ). - P. 125-131 . - PMID 1736640 .
- ↑ Breningstall GN Breath-holding spells (Eng.) // Pediatric Neurology . - 1996 .-- February ( vol. 14 , no. 2 ). - P. 91-7 . - DOI : 10.1016 / 0887-8994 (96) 00006-9 . - PMID 8703234 .