Saturday, February 11, 2012

Tuesday, July 01, 2008 SB asks

Q: Crying then sudden unconsciousness in 3-year old kid

My 3-year-old boy was nagging for something.  Then he started crying.  Suddenly, he stopped breathing, his eyes were focusless.  He was getting bluish.  His mouth was wide open but no sound came.  We tried every possible way to make him cry loud, then after aruond 30 seconds, he made some sound and then fell almost unconscous.  This incident has happened around 2/3 times in last 3 year.

 

Can anybody tell what is the problem?

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Answers (2)
7/12/08 12:00am

 

  

Hi SB,

 

I can't tell you exactly what the problem is with your child but I can tell you that it is very important that your child have an evaluation to find out what is causing the spells you described.

 

There are various heart and lung disorders that may be associated with shunting of low oxygenated blood to channels or chambers of the heart which bypass the lung where oxygen is taken up. Crying increases pressure in the chest (similar to grunting or bearing down as one would do when they are constipated and trying to pass stool). The increase in pressure within the chest may cause or enhance the shunting.

 

The passing out and breathlessness which accompanies your son's episodes is of much concern. I cannot over stress the importance of a full work-up which should be coordinated by your pediatrician or family doctor. Some non-invasive test evaluating the heart, lungs and blood should be ordered as a starting point.

 

Please give us a follow-up report (possibly create a SharePost) at your convenience.

 

 

Yours,

 

J. Thompson, MD

 

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10/23/08 10:47pm

I myself would call this a Breath Holding Spell. My son had these for about a year between the ages of 11 months and 2 years. my son would have these in the middle of a tantrum. he would scream, and then go to take a breath and faint. I would mention this to your doctor. and he may say the same thing. here is a description:

 

Definition:

A breath holding spell is an involuntary holding of the breath accompanied by loss of consciousness in response to a confrontational situation.


Causes, incidence, and risk factors:

Breath holding is seen in some normal children approximately 8 months to 2 years of age. It appears to be a reflexive response to fear, a confrontational situation, a traumatic event (for example: pain), or to being startled.

 

The child may make a short gasp and then exhale and cease breathing. Then the child rapidly becomes bluish (cyanotic) and may have several jerky movements resembling a small seizure.

The event is terminated by a momentary period of unconsciousness, at which time normal breathing resumes. The color improves with the first breath and the event is over. This behavior may be repeated several times per day or seen only on rare occasions.

Breath holding can be a frightening event for parents who may perceive it as a seizure or even cardiac arrest. Breath holding can be mistaken for a seizure, and seizures can be mistaken for breath holding.

A physician evaluation to determine that the behavior is actually breath holding is appropriate. Breath holding may also be a symptom of a rare genetic disorder, Riley-Day syndrome.

After recognizing the event as breath holding, the parent can simply await the event's natural conclusion. No undue attention should be given tothe child -- such attention might encourage a repetition of the behavior with future events.

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