title: Cardiac pacing in the management of severe pallid breath-holding attacks.
abstract: Reflex anoxic seizures (pallid breath-holding attacks) can be managed with reassurance in the majority of individuals. In a minority of cases where frequent syncopal and seizure activity occurs, intervention needs to be considered. We report a case of a 19-month infant with a history of severe reflex anoxic seizures who underwent pacemaker insertion with a spectacular result, with complete termination of syncope and seizures, and improvement in quality of life for the patient and family. A literature review of the safety and effectiveness of pacemaker insertion is also presented to support its use as a treatment option for this condition.
authors.affiliation: Greenlane Paediatric and Congenital Cardiac Services, Starship Childrens Hospital, Auckland, New Zealand. da.wilson@auckland.ac.nz
authors.forename: Dyanne
authors.initials: D
authors.lastname: Wilson
authors.forename: Philip
authors.initials: P
authors.lastname: Moore
authors.forename: A Kirsten
authors.initials: AK
authors.lastname: Finucane
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Skinner
mesh_terms: D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D020195:Epilepsy, Reflex / Q000150:complications* / Q000628:therapy; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000150:complications* / Q000628:therapy; D007223:Infant; D013575:Syncope / Q000150:complications* / Q000628:therapy