Rivista di formazione e di aggiornamento professionale del pediatra e del medico di base, realizzata in collaborazione con l'Associazione Culturale Pediatri
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Spasmi respiratori affettivi di tipo pallido con asistolia: un caso trattato con glicopirrolato
Dipartimento Materno Infantile, Unità Clinica Pediatrica, Azienda Ospedaliero-Universitaria di Parma
Indirizzo per corrispondenza: firstname.lastname@example.org
Pallid breath-holding spells (BHS) and asystole: a case treated with glycopirrolate
Key words: Stressful event, Syncope, Vagal iperreactivity with asystole, Pallor, 24 hrs Holter ECG
A 13 months-old girl was brought to our Department for several episodes characterized by the sequence: stressful event inducing pain, anger or frustration short period of crying pallor syncope spontaneous recovery of consciousness and muscle tone. In some of these episodes the syncope was followed by seizures. On the basis of medical history and clinical tests we put the diagnosis of " pallid breath-holding spells (BHS) with asystole”. They are severe forms of breath-holding spells in which the asystole lasts more than a few seconds, therefore anoxic seizures can occur. Having examined the treatment options, including a ventricular pacemaker implantation, we chose the association between an anticholinergic drug (glycopirrolate) and a positive chronotropic and stimulating the respiratory center drug (theophylline). During a follow-up period of 11 months we found that, although the patient still had many other episodes of BHS, neither syncope or seizures occurred.
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