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Efficacy of treatment with belladonna in children with severe pallid breath-holding spells

Published online by Cambridge University Press:  11 May 2018

M. Cecilia Gonzalez Corcia ,
Adrien Bottosso ,
Isabelle Loeckx ,
Françoise Mascart ,
Guy Dembour  and
Geneviève François
M. Cecilia Gonzalez Corcia*
Affiliation:
Pediatric Department and Pediatric Cardiology Departments, St. Luc Hospital, Brussels, Belgium
Adrien Bottosso
Affiliation:
Pediatric Department and Pediatric Cardiology Departments, St. Luc Hospital, Brussels, Belgium
Isabelle Loeckx
Affiliation:
Pediatric Department, Centre Hospitalier Chrétien, Liege, Belgium
Françoise Mascart
Affiliation:
Pediatric Department, Centre Hospitalier Chrétien, Liege, Belgium
Guy Dembour
Affiliation:
Pediatric Department and Pediatric Cardiology Departments, St. Luc Hospital, Brussels, Belgium
Geneviève François
Affiliation:
Pediatric Department and Pediatric Cardiology Departments, St. Luc Hospital, Brussels, Belgium
*
Author for correspondence: M. C. Gonzalez Corcia, PhD, Pediatric Cardiology Department, Cliniques Universitaires St Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium. Tel: +32 (0)2 764 13 80; Fax: +32 (0)2 764 89 11; E-mail: maria.c.gonzalez@.uclouvain.be
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Abstract

Introduction

Pallid breath-holding spells are common and dramatic forms of recurrent syncope in infancy. They are very stressful despite their harmless nature and sometimes require treatment.

Objective

The objective of this study was to evaluate the efficacy of belladonna in severe breath-holding spells.

Methods

This is a multicentric, retrospective series involving 84 children with severe pallid breath-holding spells. Inclusion criteria were >1 pallid breath-holding spell with loss of consciousness, paediatric cardiology evaluation, and follow-up >6 months. In total, 45 patients received belladonna and 39 patients did not receive treatment, according to physician preference.

Results

Mean age was 11 months, ranging from 4 to 18 months, with 54% of males. Mean spell duration was 30 seconds (interquartile range 15, 60), and the frequency was four episodes per month (interquartile range 0.5, 6.5). Comparison of baseline characteristics between groups showed similar demographics, with the single difference in the severity of the spells, being more severe in the treated group. When comparing the treated and non-treated groups at 3 months, only two (5%) patients had a complete remission in the first group, whereas 20 (44%) had remission in the belladonna group (p<0.01). When considering the characteristics of the spells before and after the initiation of treatment with belladonna, 75% of the patients presented a positive response, with 44% of the patients presenting with complete resolution of the spells (p<0.01). No major adverse reaction was reported, with only 5% minor adverse events.

Conclusions

Belladonna is highly effective to alleviate severe breath-holding spells in young children, without any major adverse effects.

Keywords

Breath-holding spellsbelladonnaatropinesyncopetreatment
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 7 , July 2018 , pp. 922 - 927
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Copyright
© Cambridge University Press 2018 

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