Breath-Holding Spells

Symptoms

The symptoms of breath-holding spells vary, depending on whether the spell is cyanotic or pallid. Cyanotic spells are caused by a change in the child's usual breathing pattern, usually resulting from strong emotions, such as anger or frustration. Pallid spells are caused by a slowing of the child's heart rate, which often is a result of pain.

In general, breath-holding spells cause a child to faint and may sometimes cause the muscles to twitch or the body to stiffen.

Specific symptoms of cyanotic spells include:

• A short burst of rigorous crying lasting less than 30 seconds.
• Hyperventilating (overbreathing).
• A pause in breathing after exhaling.
• Red or blue-purple skin color, especially around the lips.

Specific symptoms of pallid spells include:

• A single cry or no cry at all.
• Slowing of the heart.
• Pale skin color.
• Sweating.
• Sleepiness or fatigue after the episode.

If your child faints (loses consciousness) during a breath-holding spell, it usually lasts for less than 1 minute. He or she will wake up on his or her own and start to breathe again normally. When unconscious, your child may twitch.

Your child may have a seizure during a breath-holding spell. Seizures are more likely to occur if your child has long periods of breath-holding. During a seizure children may vomit or pass urine. Having a seizure as part of a breath-holding spell does not mean your child has epilepsy or another seizure disorder.

But if your child has a breath-holding spell for longer than 1 minute and also has continuous body stiffening and relaxing, he or she needs to be examined by a doctor. These symptoms may point to a seizure disorder or another medical problem.

Other conditions with similar symptoms include seizure disorders and an irregular heartbeat (arrhythmia).

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Author:	Debby Golonka, MPH	Last Updated: May 5, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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