Overuse of EEG and ECG in children with breath-holding spells and its implication for the management of the spells
(2023) In Acta Pædiatrica- Abstract
AIM: Breath-holding spells (BHS) are common in children, but evidence-based clinical guidelines are lacking. We investigated a large population-based cohort of BHS patients, to propose a refined description of typical BHS and guidelines for its management.
METHODS: In a cross-sectional retrospective study, patients diagnosed with BHS in Southern Sweden 2004-2018 were recruited. Disease characteristics and diagnostic data were collected from patient medical records.
RESULTS: In total, 519 patients, mean age at diagnosis 19.8 ± 13.8 months with equal gender distribution, were included. In 48.3%, BHS had already been diagnosed after one spell. During spells, 78.0% of patients were unresponsive. For 71.5%, atonic, tonic,... (More)
AIM: Breath-holding spells (BHS) are common in children, but evidence-based clinical guidelines are lacking. We investigated a large population-based cohort of BHS patients, to propose a refined description of typical BHS and guidelines for its management.
METHODS: In a cross-sectional retrospective study, patients diagnosed with BHS in Southern Sweden 2004-2018 were recruited. Disease characteristics and diagnostic data were collected from patient medical records.
RESULTS: In total, 519 patients, mean age at diagnosis 19.8 ± 13.8 months with equal gender distribution, were included. In 48.3%, BHS had already been diagnosed after one spell. During spells, 78.0% of patients were unresponsive. For 71.5%, atonic, tonic, tonic-clonic or myoclonic seizures were reported, and 78.0% of patients had a spell lasting less than 1 min. Electroencephalography was conducted in 30.4% and Electroencephalography in 45.1%. Six children (3.8%) had a pathological electroencephalogram, four of which had concomitant epilepsy and only 0.9% of children had electrocardiogram findings suggesting pathology, none showing long QT syndrome.
CONCLUSION: Children with BHS were frequently subjected to unnecessary diagnostic interventions. We characterise a typical presentation of BHS and propose a management-algorithm, which is expected to reduce unnecessary usage of electroencephalography and electroencephalography.
(Less)
- author
- Hellström Schmidt, Sanna LU ; Smedenmark, Julia ; Jeremiasen, Ida LU ; Sigurdsson, Björn LU ; Eklund, Erik A LU and Pronk, Cornelis Jan LU
- organization
- publishing date
- 2023-10-31
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Acta Pædiatrica
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85175490666
- pmid:37905418
- ISSN
- 1651-2227
- DOI
- 10.1111/apa.17020
- language
- English
- LU publication?
- yes
- id
- 8c9f7b27-9ae5-4c06-bfe4-513adce4994d
- date added to LUP
- 2023-11-07 09:40:41
- date last changed
- 2024-06-29 02:35:14
@article{8c9f7b27-9ae5-4c06-bfe4-513adce4994d, abstract = {{<p>AIM: Breath-holding spells (BHS) are common in children, but evidence-based clinical guidelines are lacking. We investigated a large population-based cohort of BHS patients, to propose a refined description of typical BHS and guidelines for its management.</p><p>METHODS: In a cross-sectional retrospective study, patients diagnosed with BHS in Southern Sweden 2004-2018 were recruited. Disease characteristics and diagnostic data were collected from patient medical records.</p><p>RESULTS: In total, 519 patients, mean age at diagnosis 19.8 ± 13.8 months with equal gender distribution, were included. In 48.3%, BHS had already been diagnosed after one spell. During spells, 78.0% of patients were unresponsive. For 71.5%, atonic, tonic, tonic-clonic or myoclonic seizures were reported, and 78.0% of patients had a spell lasting less than 1 min. Electroencephalography was conducted in 30.4% and Electroencephalography in 45.1%. Six children (3.8%) had a pathological electroencephalogram, four of which had concomitant epilepsy and only 0.9% of children had electrocardiogram findings suggesting pathology, none showing long QT syndrome.</p><p>CONCLUSION: Children with BHS were frequently subjected to unnecessary diagnostic interventions. We characterise a typical presentation of BHS and propose a management-algorithm, which is expected to reduce unnecessary usage of electroencephalography and electroencephalography.</p>}}, author = {{Hellström Schmidt, Sanna and Smedenmark, Julia and Jeremiasen, Ida and Sigurdsson, Björn and Eklund, Erik A and Pronk, Cornelis Jan}}, issn = {{1651-2227}}, language = {{eng}}, month = {{10}}, publisher = {{Wiley-Blackwell}}, series = {{Acta Pædiatrica}}, title = {{Overuse of EEG and ECG in children with breath-holding spells and its implication for the management of the spells}}, url = {{http://dx.doi.org/10.1111/apa.17020}}, doi = {{10.1111/apa.17020}}, year = {{2023}}, }