Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about breath holding spells.

And if you want to follow along with written notes on this topic,

you can follow along at zero definals.com slash breathholding spells

or in the neurology section of the Zero Definals Pediatrics book.

So let's get straight into it.

Breathholding spells are also known as breath holding attacks.

They are involuntary episodes during which a child holds their breath

usually triggered by something upsetting or scaring them.

They typically occur between 6 and 18 months of age.

The child has no control over the breath-holding spells.

These breath-holding spells are not harmful in the long term,

they do not lead to epilepsy and most children outgrow them by four or five years

of age. They can be divided into two types, cyanotic breath holding spells and pallid breath holding spells,

also known as reflex anoxic seizures. Firstly, let's talk about cyanotic breath holding spells.

Cyanotic breath holding spells occur when the child is really upset, worked up and crying.

After letting out a long cry, they stop breathing, become cyanotic and lose consciousness.

Within a minute they regain consciousness and start breathing.

They can be a bit tired and lethargic after the episode.

Next, reflex anoxic seizures. Reflex anoxic seizures, or pallid breath-holding spells,

occur when the child is startled. The vagus nerve

sends strong signals to the heart that causes it to stop beating. The child will suddenly

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