title: The value of neurologic and cardiologic assessment in breath holding spells.
abstract: Objective : To evaluate the value of neurologic and cardiologic assessment and also the frequency of iron deficiency anemia in children with Breath Holding Spells (BHS). Methods : The hospital charts of patients diagnosed with BHS between 2011 and 2013 were reviewed retrospectively. Results : A total of 165 children (90 boys, 75 girls) with BHS comprised the study group. A matched group of 200 children with febrile convulsions served as controls. Among the first-degree relatives, 13.3% had BHS, 1.8% had febrile convulsions and 12.1% had epilepsy. The spells were cyanotic in 140 (84.8%) children and pallid or mixed in the remainder. BNS type was simple in 46.7% of patients and complicated in the remainder. Eighteen patients had abnormalities in electroencephalography, however only one patient was diagnosed with epilepsy. Sixty nine (47.9%) patients were found to have iron deficiency anemia. Conclusion : Referral of children with clinically definite BHS to pediatric neurology or pediatric cardiology clinics and performance of echocardiography and EEG investigations for exclusion of heart disease or epilepsy appear unnecessary. However, performance of an electrocardiogram to search for prolonged QT syndrome should be considered although no patient in our series had any cardiologic abnormalities.
authors.affiliation: Unsal Yilmaz, MD; Department of Pediatric Neurology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Unsal
authors.initials: U
authors.lastname: Yilmaz
authors.affiliation: Onder Doksoz, MD; Department of Pediatric Cardiology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Onder
authors.initials: O
authors.lastname: Doksoz
authors.affiliation: Tanju Celik , MD; Department of Pediatrics, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Tanju
authors.initials: T
authors.lastname: Celik
authors.affiliation: Gulcin Akinci, MD; Department of Pediatric Neurology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Gulcin
authors.initials: G
authors.lastname: Akinci
authors.affiliation: Timur Mese, PhD. Department of Pediatric Cardiology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Timur
authors.initials: T
authors.lastname: Mese
authors.affiliation: Tuba Sevim Yilmaz, MD; Department of Public Health, Dokuz Eylul University Hospital, Izmir, Turkey.
authors.forename: Tuba
authors.initials: T
authors.lastname: Sevim Yilmaz
keywords: Breath-holding spell; Corrected QT; Electroencephalography; Iron deficiency anemia