Zamani Gholamreza, Abdi Alireza, Heydari Morteza, Ashrafi Mahmoud Reza, Tavasoli Ali Reza
Division of Pediatric Neurology, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
Department of pediatrics, faculty of medicine, Urmia University of Medical Sciences, Urmia, Iran.
Iran J Child Neurol. 2023 Fall;17(4):45-54. doi: 10.22037/ijcn.v18i1.40320. Epub 2023 Oct 26.
Breath holding spells (BHS) are a type of syncope in children that is commonly seen in the first years of life. Although these attacks do not cause serious damage to the child's brain, in severe or repeated cases, they expose the brain to hypoxia and cause a lot of stress in parents. In these cases, the clinician should consider therapy. The purpose of this study is to investigate the effectiveness of Risperidone in the treatment of BHS in children visiting the neurology clinic of the Children's Medical Center Hospital.
MATERIALS & METHODS: In this randomized clinical trial, the statistical population included patients with the history of Breath Holding spells grades 2 to 3 (after ruling out of seizure disorders) over one year old, visiting the neurology clinic of Tehran Children's Medical Center in 2019. The subjects were randomly selected from patients visiting the clinic using a table of random numbers from the admit ion list. After providing the necessary explanations and obtaining informed consent from their parents, they were treated with low-dose Risperidone (maximum 1 mg) for three months. The patients were observed for three months in terms of frequency and severity of spells monthly.
In this study, the median (25th and 75th percentile) age of subjects was 2.3 (2.0-2.6) years. Both the number and severity of seizures in the subjects had a statistically significant decrease in the period after treatment with Risperidone (P<0.001). The studied boys and girls experienced statistically significant decrease in terms of both the frequency of spells (P-value of 0.002 and 0.039) and intensity of seizures (P=0.016) and P=0.008), respectively after treatment with Risperidone. Also, in the studied children under 2 years old and over 2 years old, both the frequency (P=0.021 and P=0.004) and intensity of spells (P=0.008) 0.016 for subjects under and over 2 years, respectively) had a statistically significant decrease after treatment with risperidone compared to pretreatment.
According to the results of this study, it seems that both the frequency and the intensity of spells in children (regardless of gender and age group), experienced a statistically significant decrease after treatment with Risperidone. We suggest conducting a more comprehensive study considering a larger sample size in order to estimate this issue more correctly.
屏气发作(BHS)是儿童晕厥的一种类型,常见于生命的最初几年。虽然这些发作不会对儿童大脑造成严重损害,但在严重或反复发作的情况下,会使大脑暴露于缺氧状态,并给家长带来很大压力。在这些情况下,临床医生应考虑进行治疗。本研究的目的是调查利培酮治疗儿童医学中心医院神经科门诊就诊儿童BHS的有效性。
在这项随机临床试验中,统计人群包括2019年在德黑兰儿童医学中心神经科门诊就诊的1岁以上有2至3级屏气发作病史(排除癫痫发作障碍后)的患者。通过入院名单上的随机数字表从就诊患者中随机选取研究对象。在向其父母提供必要解释并获得知情同意后,给予低剂量利培酮(最大剂量1毫克)治疗三个月。每月观察患者发作的频率和严重程度,为期三个月。
在本研究中,研究对象的年龄中位数(第25和第75百分位数)为2.3(2.0 - 2.6)岁。利培酮治疗后,研究对象发作的次数和严重程度在统计学上均有显著下降(P<0.001)。接受利培酮治疗后,研究中的男孩和女孩在发作频率(P值分别为0.002和0.039)和发作强度(P值分别为0.016和0.008)方面均有统计学上的显著下降。此外,在研究的2岁以下和2岁以上儿童中,与治疗前相比,利培酮治疗后发作频率(2岁以下和2岁以上儿童的P值分别为0.021和0.004)和发作强度(2岁以下和2岁以上儿童的P值分别为0.008和0.016)均有统计学上的显著下降。
根据本研究结果,似乎儿童(无论性别和年龄组)发作的频率和强度在利培酮治疗后均有统计学上的显著下降。我们建议进行一项样本量更大的更全面研究,以便更准确地评估这个问题。