Department of Pediatrics, Medical University of South Carolina Children's Hospital, Charleston, South Carolina.
Department of Pediatrics, Medical University of South Carolina Children's Hospital, Charleston, South Carolina
Pediatrics. 2015 May;135(5):e1308-11. doi: 10.1542/peds.2014-2456. Epub 2015 Apr 13.
Breath-holding spells are a common childhood disorder that typically present before 12 months of age. Whereas most cases are benign, some patients have very severe cases associated with bradycardia that can progress from asystole to syncope and seizures. Treatment studies have implicated the use of several therapies, such as oral iron, fluoxetine, and pacemaker implantation. This is a retrospective study of patients treated with glycopyrrolate for pallid breath-holding spells. Clinical data from 4 patients referred to pediatric cardiology who saw therapeutic benefit from treatment using glycopyrrolate were reviewed to evaluate for clinical response to the drug. Two twin patients, whose symptoms began at 5 months of age, experienced a decrease in breath-holding frequency after 1 month. A patient diagnosed at 7 months of age experienced a decrease in frequency of spells. A patient diagnosed at 10 months of age reported cessation of syncope shortly after initiation of glycopyrrolate and complete resolution of breath-holding spells during prolonged treatment. This case study of 4 patients with pallid breath-holding offers evidence that glycopyrrolate may be beneficial in treating breath-holding spells and has a safer side-effect profile than pacemaker implantation.
屏气发作是一种常见的儿童疾病，通常在 12 个月之前出现。虽然大多数病例是良性的，但有些患者的病情非常严重，伴有心动过缓，可能从心脏停搏进展为晕厥和癫痫发作。治疗研究表明，多种治疗方法，如口服铁剂、氟西汀和起搏器植入，都可能有效。这是一项使用格隆溴铵治疗苍白屏气发作的回顾性研究。我们对 4 名转诊至儿科心脏病学的患者的临床数据进行了回顾，这些患者在使用格隆溴铵治疗后获得了治疗效果，以评估该药物的临床反应。2 名双胞胎患者的症状在 5 个月大时开始出现，在 1 个月后，屏气发作的频率有所降低。1 名 7 个月大的患者的发作频率也有所降低。1 名 10 个月大的患者在开始使用格隆溴铵后不久晕厥停止，并且在长期治疗期间完全停止了屏气发作。这项对 4 名苍白屏气发作患者的病例研究表明，格隆溴铵可能对治疗屏气发作有益，且其副作用谱比起搏器植入更为安全。
