Online ISSN: 2515-8260

Author : A.A, Khalilova


Ya.N. Madjidova; U.T. Babajanova; V.K. Abdullaeva; Sh.A. Shirmatov; Khalilova A.A

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 1673-1679

Introduction. Affective-respiratory paroxysm (ARP) or breath-holding spells is a
common phenomenon that occurs in children from 6 months to 6 years. Up to 90% of
children experience ARP for the first time before the age of 18 months. The mechanism of
the condition is still unclear. Scientists have found that children with breath-holding spells
are much more likely to be diagnosed with iron-deficiency anemia and, perhaps, it
contributes to the development of pathology. 20-35% of children have a burdened family
history. Some families have a dominant type of inheritance.
Materials and Methods. The algorithm for examining children included: general
clinical, neurological and psychological examination of children, conducting laboratory
research, registration of an electroencephalogram, according to indications, conducting an
echocardiographic study. We examined 50 children with ARP aged 6 months to 6 years.
Research was carried out in the clinic of the Tashkent Pediatric Medical Institute. The
diagnosis of ARP was established based on the history provided by mothers and
observations of seizures. Paroxysms were defined as stopping the baby's breathing at
exhalation after deep inhalation during crying. Paroxysms were classified as cyanotic,
pale, and mixed.
Results. A detailed study of the passage of the ante-, intra- and postnatal periods
made it possible to determine the significance of various unfavorable factors such as
anemia (p <0.05), toxicosis (p <0.01), acute respiratory infections (p <0.1), stress, use of
obstetric aids (p <0.05) and birth trauma. (p <0.1). In addition to perinatal risk factors, 13
(28%) children were found to have a hereditary predisposition to ARP and 4 children (8%)
to epilepsy. In most cases, seizures began at 6–12 months of age (38%). According to our
observations, the main provoking factors of seizures were: anger, inability to get what you
want - 70%, pain - 18%, fear - 12%. At clinical and neurological examination in children,
ARP of neurotic nature (82%) prevailed over affectively provoked syncope (10%) and
"epileptic" ARP (8%). The seizures in most cases were characterized by a typical course,
medium duration and high frequency. When assessing psychoemotional and behavioral
characteristics, children with ARP were more sensitive, intense, persistent, active, less
distracted, and differed in mood variability compared to healthy children. According to the
indicators of the functional state of the autonomic nervous system in children of the main
group, the initial autonomic tone was characterized by sympathicotonia, normal autonomic
reactivity was recorded significantly less than in the control group (p <0.05). According to
the results of laboratory studies, anemia (88%) and hypocalcemia (82%) were significantly
more common in children with ARP. Analysis of electroencephalographic data revealed:
signs of age norm - in 14 (28%) children, signs of dysfunction of nonspecific midline
structures of the brain - in 6 (12%) children, general cerebral changes. - in 3 (6%)