Iron supplementation should be given in breath-holding spells regardless of anemia

Authors: GÜRKAN GÜRBÜZ, PEREN PERK YÜCEL, TURGAY ÇOKYAMAN, ÖZGE BERFU GÜRBÜZ

Abstract: The purpose of this retrospective study was to determine the effectiveness of oral iron therapy in breath-holding spells and evaluation of electrocardiographical changes.Materials and methods: Three hundred twelve children aged 1-48 months and diagnosed with breath-holding spells between January 2017 and April 2018 were included. Patients' laboratory findings were compared with 100 patients who had one simple febrile seizure.Results: Cyanotic breath-holding spells were diagnosed in 85.3% (n = 266) of patients, pallid spells in 5.1% (n = 16), and mixed-type spells in 9.6% (n = 30). Sleep electroencephalograms were applied for all patients, 98.2% (n = 306) of which were normal, while slow background rhythm was determined in 1.2% (n = 4). Epileptic activity was observed in only 2 patients (0.6%). The mean hemoglobin (Hb) value in the breath-holding spell group was 10.1 mg/dL. Patients' mean corpuscular volume (MCV) was 73 fL. Patients' Hb and MCV values were statistically significantly lower than those of the control group (P < 0.001). The difference between spell burden was not statistically significant (P = 0.691). Spell burden decreased equally in both groups.Conclusion: Oral iron therapy can be administered in breath-holding seizures irrespective of whether or not the patient is anemic.

Keywords: Breath-holding spell, iron deficiency, electroencephalography

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