Reflex anoxic seizures
Reflex anoxic seizures are a common benign cause of seizure in children from a temporary lack of blood flow to the brain.
Aetiology
- In a reflex anoxic seizure, a precipitating trigger (e.g., sudden pain or vomiting) causes over-stimulation of the vagus nerve, which reduces cardiac output. This reduces blood flow to the brain, and so the brief anoxia may lead to a short seizure.
- The child recovers very quickly once oxygen supply returns, and there is no post-ictal confusion.
Diagnosis
- Diagnosis of reflex anoxic seizure is from the history.
Management
Breath holding attack
Presentation
- Breath holding spells are episodes where young children hold their breath during periods of crying to the point that they faint.
- The faint can even be accompanied by turning blue and jerking of the limbs.
- The child recovers quickly with no post-ictal confusion.
Diagnosis of breath holding attack
- Breath holding spells are diagnosed from the history alone and are not concerning.
Management
- Breath holding spells should be managed by reassuring the parents.
- There are no harmful long-term effects and no association with behavioural problems.