P BREATH HOLDING SPELLS X THEOPHYLLINE

Theophylline Is Effective in Children With Simple Breath-Holding Spells

Journal of Child Neurology

TAKE-HOME MESSAGE

• In this retrospective study, the authors compared the effectiveness of oral theophylline, piracetam, and iron treatments in children with simple breath-holding spells. Among 146 children studied, more than 80% had cyanosis associated with these spells. The frequency of monthly attacks was markedly decreased with iron (58.8%; only given to patients with iron-deficiency anemia) and theophylline (82.9%), but not with piracetam therapy (8.8%).

• Although more studies are needed to document safety and efficacy of treatment with the drugs mentioned, the results suggest that theophylline has the potential of being an option for children with breath-holding spells.

– Omar Iqbal Khan, MD

Breath-holding spells (BHS) are common nonepileptic paroxysmal events in children. This is a retrospective study to compare the effectiveness of oral theophylline, piracetam, and iron treatments in children with simple BHS. A total of 146 children (75 girls and 71 boys) with simple BHS were included to this retrospective study. Children were divided into 4 groups: nontreated (no anemia and no treatment), oral theophylline (10 mg/kg/d as a single daily dose), piracetam (40 mg/kg/d in 2 divided doses), and elementary iron (3 mg/kg/d as a single daily dose) treatments. Iron therapy had been given only in children with iron deficiency anemia. Neurologic, cardiologic, and biochemical evaluations were performed for all children. The majority of the patients had cyanotic spells (83.6%). The frequency of attacks/month was markedly decreased with iron (58.8%) and theophylline (82.9%) treatments, but not with piracetam therapy (8.8%) and nontreated group (4.7%). Satisfaction of the parents/caregivers was found to be high in the theophylline group (P < .001). Our results showed that theophylline was the most effective therapy to decrease the frequency of simple BHS in children