Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Childs Nerv Syst. 2022 Apr;38(4):813-816. doi: 10.1007/s00381-021-05247-z. Epub 2021 Jul 2.
Breath-holding spells (BHS) are commonly observed in children as a result of an autonomic nervous system disorder triggered by crying, emotional distress, or pain. There are several types of BHS and cyanotic type is one of them. We encountered a case of 3-year-old girl who presented with a delayed adaptation period and BHS 2 weeks after an endoscopic third ventriculostomy (ETV). She experienced severe headache due to increased intracranial pressure (ICP) during the delayed adaptation period, which may have contributed to the onset of BHS. Management of BHS warrants treatment of the symptoms and removal of the causative factors; in our case, intensive pain control and resolution of the increased ICP after the adaptation period were effective. While BHS are usually described as a benign condition that improves spontaneously, we highlighted the importance of recognizing and monitoring atypical symptoms such as BHS in pediatric cases.
屏气发作是儿童常见的一种自主神经系统障碍，通常由哭泣、情绪困扰或疼痛引起。屏气发作有几种类型，其中包括紫绀型。我们遇到了一例 3 岁女孩，在接受内镜第三脑室造瘘术（ETV）后 2 周出现了延迟适应期和屏气发作。她在延迟适应期因颅内压（ICP）升高而出现严重头痛，这可能导致了屏气发作的发生。屏气发作的治疗需要对症治疗和去除病因；在我们的病例中，强化疼痛控制和适应期后 ICP 的降低是有效的。虽然屏气发作通常被描述为一种良性疾病，会自发改善，但我们强调了在儿科病例中识别和监测非典型症状（如屏气发作）的重要性。
