title: [Pathophysiology, differential diagnosis and treatment of severe emotional apnea: based on report case].
abstract: BACKGROUND
  Emotional apneas (EA) are non-epileptic paroxysmal events affecting 5% of healthy children. The diagnosis is based on a stereotyped sequence of clinical events that start with tears caused by emotional stimulus, resulting in an autonomic nervous system alteration with transient color change, pale or cyanotic. 15% of the cases are associated with loss of consciousness, changes in tone or tonic-clonic movements secondary to hypoxia.
  
  
  OBJECTIVE
  To report a case of severe EA and to review the differential diagnosis and preventive treatments.
  
  
  METHODS
  A 15-month old infant with cyanotic emotional apnea since 8 months of age, triggered by pain, disgust or fear, increasing in frequency (3-4 per day) and intensity with altered consciousness and hypotonia. At 12 months, the patient also presented generalized tonic-clonic seizures of 3 minutes long, reason why the infant was admitted to the emergency service. Normal psychomotor development as well as normal physical, neurological and laboratory test results (without anemia) were found. Electroencephalography and brain MRI presented no abnormalities. Preventive therapy using Piracetam was performed in order to reduce crisis, which occurred in the first month of treatment.
  
  
  CONCLUSIONS
  In most cases, a timely information delivery to parents is enough due to the benign nature and natural history of EA. However, when the frequency and severity of EA impact the child and family, to rule out heart disease or epilepsy and to seek preventive treatment options are required.
authors.forename: Marta
authors.initials: M
authors.lastname: Hernández CH
authors.forename: Natalia
authors.initials: N
authors.lastname: Esquivel P
authors.forename: Mauricio
authors.initials: M
authors.lastname: López E
mesh_terms: D001049:Apnea / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004644:Emotions; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D018696:Neuroprotective Agents / Q000627:therapeutic use; D010889:Piracetam / Q000627:therapeutic use*; D012640:Seizures / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
chemical_list: D018696:Neuroprotective Agents; D010889:Piracetam