Katılma Nöbeti (Breath Holding)
Özet
Katılma nöbetleri çocukluk çağında sık görülen, genellikle sinirlenme, korku veya ağrı gibi tetikleyicilerle başlayan paroksismal ve epileptik olmayan bir durumdur. Siyanotik ve pallid olarak iki ana gruba ayrılan bu nöbetler, genellikle 6 ay ile 5 yaş arasında gözlenir ve 5 yaş civarında kendiliğinden kaybolur. Nörolojik hasara yol açmayan bu durumun yönetiminde aile eğitimi ve güven verilmesi temeldir, ayrıca demir eksikliği saptanırsa takviye ile atakların şiddeti ve sıklığı azaltılabilir.
Breath-holding spells are common, non-epileptic, paroxysmal events in children typically triggered by emotional stressors such as anger, fear, or pain. Categorized into cyanotic and pallid types, these events generally manifest between 6 months and 5 years of age and resolve spontaneously by age five. They do not cause permanent neurological damage, and management primarily focuses on parental education and addressing potential underlying iron deficiency to reduce the frequency and severity of attacks.
Referanslar
Leung AK. Breath- holding spells.IN: Leung AK.ed.Common problems in ambulatory pediatrics:Anticipatory guidance and behavioral pediatrics.New york: Nova Science Publishers.Inc., 2011, 97-102
Lombroso CT, Lerman P.Breath-holding spells (cyanotic and pallid infantil syncope). Pediatrics.1967; 39:563-81
Leung AKC, Leung AAM, Wong AHC and Hon KL. Breath- Holding Spells in Pediatrics: A Narrative Review of the Current Evidence. Current Pediatric Reviews, 2019;15:22-29
Anıl BG, Nedunchezian K, Jayanthini V, Pathmanabhan M. Breath Holding Spells: Evaluation of Autonomic Nervous System Function. Indian Pediatr 2005; 42(9):923-7
Arslan H, Torun E, Akkan JC, Güler S, Bayraktar S. The Evaluation of Physiological and Biochemical Parameters and the Autonomic Nervous System of Children with Breath-holding Spells. Neuropediatrics 2014;45(4):212-6
Azap SF, Siam AG, Saleh SH et all. Novel Findings İn Breath- holding spells:A cross-sectional study.Medicine(Baltimore) 2015;94(28):e1150
Gonzales Corcia MC, Bottossa A, Loeckx I, Mascart F, Dembour G, François G. Efficacy of treatment with belladone in children with severe pallid breath-holding spells. J Paediatr Child Health 2017; 53(8): 749-53
Vurucu S, Karaoglu A, Paksu SM, et all. Breath-holding spells may be associated with maturational delay in myelination of brain stem. J Clin Neurophysiol. 2014 Feb;31(1):99-101
Saad K, Farghaly HS, Badry R, Othman HA. Selenum and antioxidant levels decreased in blood of children with breath- holding spells. J Child Neurol 2014;29(10):1339-43
Tomoum H, Habeeb N, Elagouza I, Mobarez H. Peadiatric breath-holding spells are associated with autonomic dysfunction and iron deficiency may play a role. Acta Paediatr 2018; 107(4):653-7
Khurana DS, Valencia I, Kruthiventi S et all.Usefulness of ocular compression during electroencephalography in distinguishing breath-holding spells and syncope from epileptic seizures. J Child Neurol 2006;21(10):907-10
Calik M, Sen Dokumaci D, Sarikaya S, et all. Brain metabolite values in children with breath-holding spells.Neuropsychiatr Dis Treat 2017;13:1655-60
Orii KE, Kato Z, Osamu F, et all. Changes of Autonomic nervous system function in patients with breath- holding spells treated with iron.J child Neurol 2002; 17(5):337-40
Zehenter AA, Orr N, Buckmaster A, Williams K, Wheeler DM. Iron supplementation for breath-holding attacks in children.Cochrane Database Syst Rev 2010;(5):CD008132.
Jain R, Omanakuttan D, Singh A, Jajoo M. Effect of iron supplementation in children with breath holding spells. J Paediatr Child Health 2017;53(8):749-53
Gonzalez Corcia MC, Bottossa A, Loeekx I, Mascart F, Dembour G, François G. Efficacy of treatment with belladonna in children with severe pallid breath-holding spells. Cardiol Young 2018;28(7):922-7
Williams J, Cain N. Case report of successful treatment of pallid breath-holding spells with glycopyrolate. Pediatrics 2015;135(5): e1308-e1311
Walsh M, Knilans TK, Anderson JB, Czosek RJ,Successful treatment of pallid breath-holding spells with fluoxetine. Pediatrics 2012;108(3):765-6
Ergul Y, Otar G, Nisli K, Dindar A. Permanent cardiac pacing in a 2.5 month-old infant with severe cyanotic breath-holding spells and prolonged asystole. Cardiol J 2011;18(6):704-6
Sawires H, Botrous O. Double-blind, placebo- controlled trial on the effect of piracetam on breath-holding spells. Eur J Pediatr 2012; 17(7):1063-67
Calik M, Oguz E, Sarikaya S, Kandemir H, Yoldaş TK. Melatonin can be used to treat childhood breath-holding spells. J Child Neurol. 2015; 30(8):1089
