Affective respiratory attack in infants. Affective-respiratory attacks. Breath holding attacks - causes, treatment

Affective-respiratory attacks Medicamente non medicamentis

One of the most "adored" topics for conversation in the office pediatric neurologist. There are times when a wonderful and obedient baby, due to the failure of his desire, anger or discontent, suddenly begins to cry bitterly, screaming, sobbing and rolling. During strong crying, at the height of the strongest negative emotions (affect), his breathing suddenly stops at the moment of inhalation, the child “turns off the sound”, although the mouth is open, it becomes like a “rag”, becomes soft, turns pale, or even turns blue. Naturally, a loving mother "goes limp" and almost faints after him. And if, at the same time, the child arches and a “stone” tension of the muscles of the body, arms, legs or twitches (tonic or clonic convulsions), impaired consciousness, involuntary urination - even harsh men, dads and grandfathers, fall into a slight panic!
Again, the sight is often frightening, not for the faint of heart. Usually, this state does not last long, more often, after a few seconds, breathing is restored, the child comes to his senses. But believe me - these seconds seem like an eternity to mom! Sometimes it may seem that the child makes such “rolling” with a stoppage of breathing consciously, but this is most likely not the case. Plays the main role here reflex mechanism, respiratory arrest occurs at the moment of almost complete exhalation of air from the lungs at the beginning of the intended inhalation.
According to various sources, affective-respiratory seizures are recorded in approximately 10-15% of all seizures in children from 6-12 months to 3-4 years old, mainly in smart and cunning, hyperexcitable and capricious babies. Most experts believe that affective-respiratory attacks refer to the expression of hysterical symptoms or "neurotic" syncope of early childhood. Translated into normal human language, affective-respiratory attacks sound like sudden stops in breathing, sometimes with impaired consciousness, against the backdrop of a powerful, uncontrollable emotion.
For example, if the desire of a beloved one-year-old remains without

Affective-respiratory attacks (ARP) are conditions of involuntary respiratory arrest, which are often accompanied by convulsions. They occur in children under 5 years of age, and usually disappear with age. And although such attacks are not related to diseases, their symptoms seriously scare parents. The frequency and strength of seizures is sometimes so high that physicians speak of a paroxysm. So what are the causes of such conditions and how to deal with them?

In most cases, seizures are divided into 2 types:
blue and pale. These names are determined by the color of the skin that the child acquires during ARP. However, other conditions are also possible, so when diagnosing, doctors rely on an extended classification:

1. Simple ARP:
   • slight breath holding;
   • blood flow does not change;
   • convulsions are absent;
   • skin color stays the same.
2. Blue type:
   • the child breaks into hysterical sobs;
   • breathing stops;
   • the skin turns blue;
   • muscle tone weakens;
   • possible loss of consciousness and convulsions.
3. Pale type:
   • crying may be small or completely absent;
   • the skin turns pale;
   • the rest of the symptoms are similar to seizures in the blue type.
4. Complex type:
   • the initial stage does not differ from other states;
   • escalates to the point of an epileptic seizure.

When identifying similar symptoms don't panic right away. Usually the attack passes without any intervention, but if it lasts longer than 1 minute, then call " ambulance» is a must. And even in the case of a short-term seizure (30-40 seconds) You should at least see a doctor for advice.

AT medical practice no evidence of serious complications as a result of such paroxysms. In addition, after 5 years in children, affective-respiratory syndrome practically does not occur in its classical form. However, at an older age, epilepsy attacks are possible, which, despite the similarity with ARP, still have differences.

What is the difference between epilepsy and ARP?

At the first case of an affective-respiratory attack, parents begin to suspect that the child has epilepsy. These are very hasty conclusions. Do not confuse these concepts, because the difference between them is obvious:

• ARP usually precedes nervous tension, a epileptic seizures— spontaneous;
• ARP may have different intensity, and epileptic ones are always the same;
• ARP is observed only up to 5-6 years, and epilepsy does not depend on age;
• ARP can be warned medications and epilepsy does not stop.

In addition, a study of the brain of children suffering from affective-respiratory attacks did not show any changes in it. But in the case of epilepsy EEG demonstrates epistatus, i.e., the frequently repeated collective activity of neurons.

The reasons

Doctors focus on the fact that affective-respiratory attacks are neurological in nature. Seizures are sometimes considered precursors of hysteria and syncope in adulthood.

Such statements are not without foundation! Young children often get what they want with the help of sobbing, and if the situation is not corrected, then an adult will also resort to similar methods. And this will usually happen unconsciously.

However, there is some difference between such paroxysms. For example, blue type ARP occurs just in the case crying, anger or simple displeasure.

And holding the breath with blanching usually acts as a reaction to physical pain(fall, blow, injection, etc.). In addition, in excitable and capricious children, such paroxysms are much more common, so the cause of the disorder must be sought primarily in psychological environment within the family. After all, excessive indulgence of the child, increased guardianship, scandals between parents - all this creates unfavourable conditions for normal development the psyche of the baby and the formation of his character.

Neurological nature of affective-respiratory attacks is a common but not the only reason. Respiratory failure may indicate bronchial asthma or the presence of a foreign body in respiratory tract. The loss muscle tone, in which the baby's body literally goes limp, can develop both in the event of a heart rhythm failure, and as a reaction to medications, and during normal overheating of the body.

And one more point requires attention: in many children suffering from such paroxysms, a blood test often shows reduced level hemoglobin. The result is usually anemia, which leads to hypoxia - oxygen starvation of tissues.

And one of the signs of this condition is blanching or blue skin. If the child is sick bronchial asthma, then the symptoms may well be confused with ARP. However, interviewing eyewitnesses of the attack and examining the baby will allow the doctor to specify the diagnosis.

ARP and seizures

Seizures in children are often accompanied by convulsions. Although the mechanism of their occurrence is quite complex, doctors agree that psychogenic factors play a major role in this case. But hypoxia should not be written off. Usually events develop according to the following scenario:

Some people believe that splashing water or tickling will bring the baby to life. This is a wrong belief. Convulsions occur at an unconscious level, so it is better to wait for them to stop on their own.

The positive point is that they are short in time (about 1 minute). However, this fact does not detract from the experiences of parents who see this with their child.

Treatment

Regular affective-respiratory attacks are increasingly inclining adults to think about treating the baby. And although seizures are not considered a disease, you can get rid of them or reduce the likelihood of occurrence with both medication and folk remedies. Critical importance has the creation of favorable relationships within the family, with which it is necessary to begin consideration of methods of treatment.

Psychotherapy

ARP arise on nervous ground. And the baby is not able to resist the seizures on his own. In addition, the child does not have social skills, so it is pointless to demand understanding from him. At the age of 2-3 years, children are very receptive to the environment, because they are just beginning to explore the world. And parents are role models.

How often does it happen that the hysterical behavior of adults is copied by the child at an unconscious level. For example, parents swear, proving their point of view.

But no one wants to hear each other. As a result, the baby will also not perceive the words, but will immediately throw a tantrum.

So who needs psychotherapy in the first place? Of course, mom and dad should learn how to talk normally so that the child also receives the necessary skills.

However, this is not the only scenario. After all, it also happens that parents a good relationship among themselves: love reigns in the family! And this love leads to excessive indulgence of the desires of the child. The result is usually tantrums for any reason (toys, sweets, cartoons, etc.), which most often cause blue-type ARP.

Bans are perceived by many as an educational process. You can’t do without them, otherwise the baby will not learn elementary rules behavior. You can forbid in different ways: with a threatening cry or affectionate and kind, but hard word. At an early age, instincts prevail, so even a sense of danger from parents can cause a tantrum. Those people from whom the danger should not come, especially in the first years of life. However, these questions directly relate to the psychology of education, therefore, with frequent affective-respiratory attacks, you should contact your pediatrician. The doctor will assess the situation, help find the right solution to the problem, and refer you to a neurologist or psychotherapist if necessary.

Medicines

One of the options for getting rid of seizures is medication. And for this purpose, nootropic and sedatives, which increase the resistance of the brain to hypoxia, reduce psycho-emotional stress and aggressiveness:

• Pantogam;
• Glycine;
• Pantocalcin;
• Phenibut etc.

Drink medicines usually within 2 months. And although such drugs are dispensed in a pharmacy without a prescription, it is still necessary to consult a doctor, otherwise, instead of improving the condition, complications can be earned.

Conclusion

Affective-respiratory seizures occur with different frequency, but in each case, parents are frightened by such conditions of the child. And although nothing can help the baby at the time of the attack, there are still ways to prevent tantrums and convulsions.

Doctors do not see ARP as a special reason for unrest and recommend, first of all, to normalize the emotional background in the family. In addition, seizures usually disappear after 5 years of age, so a little parental patience and good word save the child from suffering in most cases.

Respiratory attacks in children are a condition characterized by abnormal breathing and sometimes seizures. Such a violation is paroxysmal in nature and can seriously frighten parents.

Often in various sources you can find the abbreviation ARP - affective-respiratory attack. Pathology is characterized by paroxysms and sudden stop breathing.

An attack of ARP occurs at the moment of psycho-emotional arousal. When a child starts crying, at the height of inhalation, breathing stops for 10-15 seconds. This may be accompanied by a change in complexion or sudden disruption motility.

Stopping breathing during an attack is a reflex reaction of the body to the strong emotions experienced by the infant. Such an attack occurs in several cases:

• while crying;
• when frightened;
• if the baby hurts.

Parents are very frightened when they first encounter this disorder. At the moment of crying, the child suddenly calms down abruptly, his skin turns pale or turns blue, while he opens his mouth, but cannot make a sound. As a rule, this state lasts no more than 40 seconds.

There is a relationship between a change in the color of a child's skin and the emotions experienced at that moment. Skin blanching is observed in the following cases:

• the fall;
• injury;
• fear;
• hit.

Often, the child does not have time to respond by crying to the pain experienced, as soon as an affective attack begins. The danger of this condition lies in the fact that parents may not notice the traumatic effect and not understand why the child's skin turns pale, and he cannot breathe.

Another type of ARP is accompanied by cyanosis of the baby's skin during an attack. The reason for such a reaction is often bright emotions - the child may be dissatisfied or annoyed. Not getting what he wants, the baby begins to cry a lot. At the moment when it is necessary to take a breath in order to continue crying, there is a sudden cessation of breathing. At this time, the skin of the face acquires a bluish tint.

During an attack, it is possible to increase the tone of the muscles of the body. The child may suddenly arch as if he had a cramp. As a rule, this condition goes away on its own and lasts no more than a few minutes.

What you need to know about ARP

The children's nervous system reacts sharply to any stressful situations therefore, ARP in children is not uncommon and not a cause for panic. Violation at least once in a lifetime occurs in every fourth child under the age of four years.

If the violation is not associated with organic pathologies, brain diseases or lack of important trace elements parents don't have to worry. You can get rid of the disorder on your own, without the use of drug therapy however, this requires patience.

Having understood the mechanism of the development of seizures, in no case should you scold the child or ask him to stop. Breathing stops reflexively, in response to crying, and the baby himself cannot do anything about it.

Despite the frightening symptoms, seizures are not harmful to health. With age, the human nervous system becomes stronger and affective attacks disappear without a trace.

Why do seizures occur with ARP?

Convulsive states during an affective attack are rare. Typically, these symptoms accompany a breath hold of more than 40 seconds. The child suddenly goes limp, loses consciousness and falls to the floor. At the same time, his body begins to move convulsively.

Often, parents, not knowing about the causes of the seizure, begin to suspect epilepsy. However, such seizures are non-epileptic in nature, and arise due to a lack of oxygen supplied to the brain.

Seizures in ARP occur as defensive reaction nervous system to the tested oxygen starvation brain, as in an unconscious state, the need for oxygen is greatly reduced.

Holding your breath causes carbon dioxide to build up. This, in turn, causes the child to reflexively take a breath, after which the attack stops and the baby regains consciousness.

Since during an attack the body experiences a strong load, usually, after the baby has come to his senses, he plunges into deep sleep for 2-3 hours.

Are seizures dangerous?

By themselves, seizures that develop against the background of emotional stress do not pose a danger. However, parents need to consult a pediatric neurologist to rule out the epileptic nature of seizures.

It is imperative to consult a pediatrician, since in some cases attacks may indicate a deficiency of certain trace elements and vitamins.

How to treat

Treatment of the disorder is based on minimizing stressful situations to which the child is exposed.

If seizures recur frequently, a neurologist should be consulted. Although ARP is treated in a non-drug way, in some cases, the child may be recommended lungs sedatives. If a deficiency of vitamins and microelements is detected, the treatment is supplemented with special preparations.

Parents themselves play an important role in getting rid of seizures. According to statistics, overprotective children or babies experiencing attention deficits are susceptible to affective-respiratory attacks.

Parents should be supportive of their child, but not overprotective. If a child, accustomed to getting everything on demand, does not receive proper attention at a certain moment, he begins to have an attack. To avoid this, you should properly engage in education.

The kid must accurately understand the boundaries of what is permitted. Explaining this is the primary task of parents faced with ARP.

One more probable cause Violations are frequent stressful situations that arise due to a lack of understanding in the family. In this case, psychotherapy for parents will help get rid of an attack in a baby.

An important role for the prevention and treatment of ARP is played by the daily routine of the child. It is necessary to strictly follow the schedule and ensure that the child has a healthy leisure time. Children suffering from recurrent seizures should avoid watching TV and cartoons for a long time.

Prevention

ARP and paroxysms during an attack are one of the first manifestations of hysteria in a child. Parents should remember - no one is born hysterical, children become so because of the emotional atmosphere in the family.

To avoid the development of seizures, you must:

• clearly outline the boundaries of what is permitted for the child;
• do not scream or punish the baby;
• give the child enough attention, but avoid overprotection;
• treat the child like an adult.

If love and mutual understanding reign in the family, children do not throw tantrums for the slightest reason. the main task parents is to do everything so that the child in the family feels loved and protected.

Apnea in infants

Apnea is a sudden stoppage of breathing that is not associated with emotional load. Infants and newborns are susceptible to the disease. In adults, apnea can occur during times of severe skin irritation.

Of particular danger is the sudden stoppage of breathing during sleep apnea. In this case, breathing stops for more than 25 seconds, which may have Negative consequences for a child. The disorder should be treated, otherwise a number of neurological pathologies, up to the violation of the development of the baby.

Sudden disruption of breathing during sleep is a cause for concern. In infants, a violation can develop for the following reasons:

• trauma during childbirth;
• congenital anomalies of the structure of the nose;
• swelling of the mucous membrane of the nasopharynx with colds and viral diseases;
• severe obesity.

At an older age, such disorders are rare. Respiratory arrests in children over 8 months of age are directly related to emotional state child and, according to many experts, are the first harbingers of neurosis and hysteria in the future.

What to do with apnea

Sleep apnea in a newborn serious danger for good health. Upon noticing the symptoms of sudden respiratory arrest in an infant, parents should immediately call for emergency medical care.

First of all, you need to wake up the baby. Parents should then lightly massage the limbs and earlobes to restore normal blood circulation. If after 20 seconds after stopping breathing the child could not take a breath, you should carefully make several exhalations of artificial respiration. Be sure to remember that the lungs of the baby are small, and exhalation when artificial respiration should be quite small.

In addition, you need to make sure that the cause of respiratory arrest is not foreign objects in the baby's throat. For this, the baby should be picked up, his head carefully tilted back and his throat carefully examined.

Apnea, unlike ARP, is very dangerous violation, which requires careful diagnosis by a neurologist and treatment. Faced with a sudden cessation of breathing in a dream, it is urgent to call an ambulance, and then go through all the necessary examinations.

If the attack does not pose a serious health hazard and is successfully treated by normalizing family relations, apnea must be diagnosed in a timely manner in order to avoid aggravating the disease.