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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Children's Health Breath holding spells or expiratory apnea

Breath holding spells or expiratory apnea

A breath-holding spell is an episode in which the child stops breathing and loses consciousness for a short period immediately after frightening or emotionally upset. It occurs in 5% of healthy children. It usually occurs between the age of 6 months and 5 years. It is often mistaken for seizures.

There are two forms of breath holding spells.

The cyanotic form: It is precipitated by anger or frustration. When the child is crying the air is exhaled from the lungs. After a bout of crying most of air in lungs are exhaled. Vocal cords are narrowed or closed during crying. The lungs are held in expiration for a few seconds and the child becomes blue. There is rigidity, opisthotonus followed by limpness. Thereafter the child recovers consciousness and become less active for short period.

The pallid forms of spells are precipitated by fear or minor injury. In this the child becomes pale.Some children can have both cyanotic and pallid spells at any time or another in their lives.It is usually not serious and do not cause permanent damage or affect child’s health

Causes of breath holding spells:

  • The spells occur if there is change in usual breathing pattern or slowing of heart rate.
  • In some children the spells may be related to iron deficiency anemia.


  • Measures should be taken to prevent precipitating factors.
  • The attack could be aborted by strong stimulus like pinch.