Breath-holding (Participation) Bouts
• Occurs in children aged 3 months to 6 years.
It develops due to prolonged expiratory apnea or intrapulmonary shunt.
• The child begins to cry and then holds his breath. Generally, a fit of seizure lasts a few seconds or minutes.
If the attack ends without loss of consciousness, it is defined as a "simple attack". If the pause in expiration is prolonged, cyanosis or paleness increases, resulting in loss of consciousness, which is defined as a 'severe' or 'complicated attack'. Not during inspiration. During complicated seizures, tonic, tonic-clonic contractions and urinary incontinence can sometimes be observed.
• It is a benign disorder. It limits itself.
• Iron deficiency anemia may cause this picture. It must be treated.
• The frequency of seizures may vary (8-10 seizures/day or seizure-free for months).
• If the seizure is short, postictal sleep/somnolence may be seen in normal, long-lasting seizures after the seizure.
Hyperexplexia
• It is a rare, sporadic, and sometimes dominantly inherited disease.
• The genetic cause is a defect in the alpha and beta subunits of strychnine sensitive glycine receptors. The typical triad is general body rigidity, nocturnal myoclonus, and pathological startle reflex.
• Artifacts caused by muscle contraction in the EEG during contraction may be confused with spike waves. In its severe forms, even hypoxic brain damage can occur.
• The neonatal form of stiffness improves by the age of 1 and disappears during sleep.
• Congenital causes of rigid baby syndrome; Congenital solid man syndrome, startle epilepsy, myoclonic seizures, neonatal tetany, phenothiazine toxicity, Schwartz-Jampel syndrome.
• Clonazepam is used in the treatment.
Other Tables Imitating Convulsion:
• Vagal syncope
• Cardiac syncope
• Familial hemiplegic migraine
• Benign paroxysmal vertigo
• Alice in Wonderland Syndrome (Cause unknown. Temporary visual hallucinations, perceiving body parts in different sizes)
• Syncope due to migraine
• Psychological disorders
• Spasmus nutans
Spasmus nutans is a special type of acquired nystagmus.
The characteristic triad of this type of nystagmus, which occurs between 1-2 years of age, is pendular nystagmus, nodding, and torticollis.
It shows a self-limiting and benign course. It usually disappears before the age of 5.
However, caution should be exercised as hypothalamic and optic chiasma gliomas may also produce similar findings.
