Spells In Infants Research Articles

Breath-holding spells in infants as a defense emotional reaction: A case presentation

Introduction: Emotional affect in infants can occur without identifying a stimulus and can be based on an automatic reconstruction of a reaction pattern. Nonepileptic paroxysmal disorders, such as breath-holding spells (BHSs), are a frequent pattern of emotional reaction in todlers. Intense development of nervous system is closely connected with both social and emotional development and is influenced by most immediate family environment. Aim: Aim of this work was to present clinical case of a child with respiratory arrest and effects of psychological therapeutic interventions. Case study: An 11-month-old child with manifestations of respiratory arrest while crying was examined using the child’s developmental scale in order to determine the child’s developmental resources in psychomotor area. An interview and a neurological examination confirmed the initial diagnosis of BHSs. Psychological tests assesed development of the patient as average/high in relation to a peer group. Therapeutic sessions with parents aimed at implementing positive changes in child’s home environment. Results and discussion: Therapeutic psychological interventions resulted in cessation of fits of apnea in the patient. Psychological testing performed 6 months later still described the psychomotor development of the child as average/high in the performance scale. However, important differences in the area of temperamental features were recorded. Conclusions: (1) Improvement obsereved after implemented psychological indications allows to conclude that BHSs presented by the child were a defense emotional reaction to an unfavourable home environment. (2) Emotional development of a child should be understood in a multifaceted way.

Some aspects of clinical relevance in the maturation of respiratory control in infants

Two reflex mechanisms important for survival are discussed. Brain stem and cardiovascular mechanisms that are responsible for recovery from severe hypoxia (autoresuscitation) are important for survival in acutely hypoxic infants and adults. Failure of this mechanism may be important in sudden infant death syndrome (SIDS), because brain stem-mediated hypoxic gasping is essential for successful autoresuscitation and because SIDS infants appear to attempt to autoresuscitate just before death. A major function of another mechanism is to protect the airway from fluid aspiration. The various components of the laryngeal chemoreflex (LCR) change during maturation. The LCR is an important cause of prolonged apneic spells in infants. Consequently, it also may have a role in causing SIDS. Maturational changes and/or inadequacy of this reflex may be responsible for pulmonary aspiration and infectious pneumonia in both children and adults.

Breath-holding—like spells in an infant: An unusual presentation of lingual thyroglossal duct cyst

The authors report the case of an infant with a lingual thyroglossal duct cyst who presented with breath-holding-like spells, which actually represented life-threatening ball-valve obstruction of the larynx, leading to hypoxemia and transient cerebral dysfunction. When evaluating apparent breath-holding spells in young infants, physicians should include dynamic, episodic upper airway obstruction in the differential diagnosis. J Pediatr Surg 35:1381-1384. Copyright © 2000 by W.B. Saunders Comapny.

Esmolol for the treatment of hypercyanotic spells in infants with tetralogy of Fallot

Etude de deux cas cliniques chez des nourrissons avec une tetralogie de Fallot. L'efficacite du traitement par le bloquant β-adrenergique esmolol pour les cardiopathies cyanogenes est demontree

Oscillatory breathing patterns leading to apneic spells in infants.

Oscillatory breathing patterns leading to apneic spells in infants.

Prolonged Apnea

Prolonged apneic spells in infants may lead to morbidity and occasional mortality. Prolonged apnea is defined as cessation of breathing for 20 seconds or longer, or as a briefer episode associated with bradycardia, cyanosis, or pallor. Present etiological considerations in prolonged apnea include seizure disorders, severe infections, significant anemia (especially in infants who were preterm), gastroesophageal reflux, hypoglycemia and other metabolic disorders, and impaired regulation of breathing. It further seems likely that some victims of the sudden infant death syndrome (SIDS) have succumbed to unrelieved prolonged apnea. Beyond specific treatment of any underlying disorder, 24-hour surveillance is critical to the management of prolonged apnea. Settings for intensive observation and care may include the appropriately staffed and equipped acute care hospital, and the infant's home. In addition, a long-term care facility or foster home may be considered. Skilled care-givers are crucial to continuous observation and management of an infant in any setting. Care-givers should be trained in infant cardiopulmonary resuscitation and provided with continuing medical, technical, and psychosocial support. In the home setting, relief personnel should be available. Electronic or other monitors of the heart or respiratory rate may be useful adjuncts to 24-hour surveillance, but should be used only under medical supervision. There is presently no consensus concerning the relative advantages and disadvantages of cardiac and respiratory monitors-both present problems. Moreover, a successful outcome for every baby with prolonged apnea cannot be guaranteed, despite continuous surveillance (with or without monitors) and appropriate intervention. Pediatricians must keep in mind that there is a significant psychological impact on all the members of the family of an infant with prolonged apneic spells, whether or not monitors are included in the management plan.