++
This is a dramatic emergency. There are two types: one related to a tantrum (description follows) and the other a simple faint. They can manifest as ‘blue attacks’ (breath holding with closed glottic) or ‘white attacks’ known as reflex anoxic seizures, usu. with pain.
++
++
Age group—usu. 6 mths to 6 yrs (peak 2–3 yrs)
Precipitating event (minor emotional or physical)
Children emit a long loud cry, then hold their breath
They become pale and then blue
If severe, may result in unconsciousness or even a brief tonic–clonic fit
Lasts 10–60 secs
++
++
Place child in coma position
Reassure the parents that attacks are self-limiting, not harmful and are not associated with epilepsy or mental retardation (usu. resolve by 3 yrs)
Advise parents to maintain discipline and to resist spoiling the child
Try to avoid incidents known to frustrate the child or to precipitate a tantrum: try distraction techniques