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The diagnosis of a breath-holding spell is made clinically. A good history including the sequence of events, lack of incontinence and no postictal phase, help to make an accurate diagnosis. Some families are advised to make a video recording of the events to aid diagnosis. An electrocardiogram (ECG) may rule out cardiac arrhythmia as a cause. [1]
Periodic breathing is clusters of breaths separated by intervals of apnea or near-apnea. As opposed to normal breathing which is usually regular, periodic breathing is defined as three or more episodes of central apnea lasting at least 4 seconds, separated by no more than 30 seconds of normal breathing.
Apnea (also spelled apnoea in British English) [1] is the temporary cessation of breathing.During apnea, there is no movement of the muscles of inhalation, [citation needed] and the volume of the lungs initially remains unchanged.
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In very young infants under six weeks of age, especially premature infants, signs of infection may be less specific. They may have minimal respiratory involvement. Instead, they may exhibit decreased activity, irritability, poor feeding, or breathing difficulties. This can also be accompanied by apneic spells, or brief pauses in breathing. [4] [23]
The conditions of hypoxia and hypercapnia, whether caused by apnea or not, trigger additional effects on the body.The immediate effects of central sleep apnea on the body depend on how long the failure to breathe endures, how short is the interval between failures to breathe, and the presence or absence of independent conditions whose effects amplify those of an apneic episode.