A 2yo boy fell off his tricycle and hurt his arm. He got up to start crying, but before there was
any sound, he went pale, unconscious and rigid. He recovered after 1-2 mins but remained pale.
After an hour he was back to normal. His mother says she was afraid he was going to die, and
that he had a similar episode 3 months prior after falling down some steps. What single inv is
indicated?
a. CT head
b. EEG
c. CBC
d. None
e. Skeletal survey
answer D
Breath-holding spells are brief periods when young children stop
breathing for up to 1 minute. These spells often cause a child to pass
out (lose consciousness).
• epidemiology: 0.1-5% of healthy children 6 mo-4 yr of age, usually start during first year of life
• etiology: child is provoked (usually by anger, injury, or fear) > holds breath and becomes silent > spontaneously resolves or loses consciousness
But the spell is a
reflex. Children don't have breath-holding spells on purpose. Children will grow out of these spells.
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