The attack is affective respiratory at one month. Affective-respiratory attacks. Attacks of holding your breath - causes, treatment. ARP and child health

Affective respiratory seizures in children are a condition characterized by abnormal breathing and sometimes seizures. This disorder is paroxysmal in nature and can seriously frighten parents.

Often in various sources you can find the abbreviation ARP - affective-respiratory attack. The pathology is characterized by paroxysms and sudden cessation of breathing.

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

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

while crying;
when frightened;
if the baby gets hurt.

Parents are very frightened when they encounter this disorder for the first time. At the moment of crying, the child suddenly suddenly becomes quiet, his skin turns pale or 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 the change in the color of a child’s skin and the emotions experienced at that moment. Pallor of the skin is observed in the following cases:

a fall;
injury;
fear;
hit.

Often, the child does not have time to react by crying to the pain he is experiencing, when an affective attack immediately begins. The danger of this condition is that parents may not notice the traumatic effect and may not understand why the child’s skin turns pale and he cannot take a breath.

Another type of ARP is accompanied by bluish skin of the baby during an attack. The reason for this reaction is often strong emotions - the child may be dissatisfied or irritated. 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, a sudden stop in breathing occurs. At this time, the skin of the face acquires a bluish tint.

During an attack, it is possible to increase the tone of the body muscles. The child may suddenly arch as if he was having a seizure. 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, so ARP in children is not uncommon and not a reason to panic. The disorder occurs at least once in a lifetime in every fourth child under the age of four.

If the disorder is not associated with organic pathologies, brain diseases or a lack of important microelements, parents do not need to worry. You can get rid of the disorder on your own, without the use of drug therapy, but this will require patience.

Having understood the mechanism of development of attacks, under no circumstances should you scold the child or ask him to stop. Stopping breathing occurs reflexively, in response to crying, and the baby himself cannot do anything about it.

Despite the frightening symptoms, the attacks are not harmful to health. With age, a person’s nervous system strengthens and affective attacks disappear without a trace.

Why do seizures occur with ARP?

Convulsive states during an affective attack are rarely observed. Typically, such symptoms accompany holding the breath for 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 the causes of the seizure, begin to suspect epilepsy. However, such seizures are non-epileptic in nature and occur due to a lack of oxygen supplied to the brain.

Convulsions during ARP occur as a protective reaction of the nervous system to the experienced oxygen starvation of the brain, since in an unconscious state the need for oxygen is greatly reduced.

Due to holding your breath, there is an accumulation of carbon dioxide. This, in turn, forces 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 comes to his senses, he falls into a sound sleep for 2-3 hours.

Are seizures dangerous?

The attacks themselves, which develop against the background of emotional stress, are not dangerous. However, parents need to consult a pediatric neurologist to exclude the epileptic nature of seizures.

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

How to treat

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

If attacks recur frequently, consultation with a neurologist is necessary. Although ARP is treated non-pharmacologically, in some cases a child may be recommended to take mild sedatives. If a deficiency of vitamins and microelements is detected, treatment is supplemented with special medications.

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

Parents should support their child, but not be overprotective. If a child, accustomed to receiving everything on demand, at a certain moment does not receive due attention, he begins to have an attack. To avoid this, you should educate yourself correctly.

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

Another probable cause of the disorder is frequent stressful situations that arise due to a lack of mutual understanding in the family. In this case, psychotherapy for parents will help get rid of the baby’s attack.

A child’s daily routine plays an important role in the prevention and treatment of ARP. It is necessary to strictly follow the schedule and provide the child with healthy leisure time. Children suffering from recurrent seizures should avoid watching television and cartoons for long periods of time.

Prevention

ARP and paroxysms during an attack are one of the first manifestations of hysteria in a child. Parents must remember that no one is born hysterical; children become like this because of the emotional atmosphere in the family.

To avoid the development of attacks it is necessary:

clearly outline the boundaries of what is permitted for the child;
do not shout 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 at the slightest provocation. The main task of parents is to do everything so that the child in the family feels loved and protected.

Apnea in infants

Apnea is a sudden stop in breathing that is not associated with emotional stress. Infants and newborns are susceptible to the disease. In adults, apnea may occur during severe skin irritation.

A particular danger is the sudden cessation of breathing during sleep apnea. In this case, breathing stops for more than 25 seconds, which can have negative consequences for the child. The disorder should be treated, otherwise a number of neurological pathologies may develop, including disruption of the baby’s development.

Sudden breathing problems during sleep are a cause for concern. In infants, the disorder may develop for the following reasons:

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

At older ages, such disorders are rarely observed. Stopping breathing in children over 8 months of age is directly related to the emotional state of the child and, according to many experts, is the first harbinger of neurosis and hysteria in the future.

What to do with apnea

Sleep apnea in a newborn poses a serious health risk. If parents notice symptoms of sudden respiratory arrest in an infant, they should immediately call emergency medical help.

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, 20 seconds after stopping breathing, the child is still unable to take a breath, several exhalations of artificial respiration should be carefully performed. It is imperative to remember that the baby’s lungs are small, and exhalations during artificial respiration should be very small.

In addition, you need to make sure that the cause of respiratory arrest is not foreign objects in the baby’s larynx. To do this, you should pick up the baby, carefully tilt his head back and carefully examine his throat.

Apnea, unlike ARP, is a very dangerous disorder that requires careful diagnosis by a neurologist and treatment. When faced with a sudden stop in breathing during sleep, you must urgently call an ambulance and then undergo all the necessary examinations.

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

AFFECTIVE-RESPIRATORYSEIZURES.Affective-respiratory attacks, or paroxysms, seizures (ARP), breath-holding spells, (in common parlance - rolling up) are sudden short-term stops of breathing at the height of inspiration with the inability to exhale, occurring when crying in infants or young children. In this case, the child turns blue or pale to one degree or another. One of the frequently encountered questions regarding emergency care in the practice of pediatricians and child neurologists, this condition is very frightening for parents, so I’ll tell you more about it.

Affective-respiratory attacks (attacks of breath holding) are the earliest manifestation of fainting or hysterical attacks. The word "affect" means a strong, poorly controlled emotion. "Respiratory" is something that has to do with the respiratory system. Seizures usually appear at the end of the first year of lifeand can last up to 2-3 years of age. Although holding their breath may seem deliberate, children usually do not do it on purpose. This is simply a reflex that occurs when a crying child forcefully exhales almost all the air from his lungs. At this moment he falls silent, his mouth is open, but not a single sound comes from it. Most often, these breath-holding episodes do not last more than 30-60 seconds and pass after the child catches his breath and starts screaming again.

At this time, parents begin to panic, although this, you see, is not the best help for the child. Therefore, I will present all the materials that I managed to collect on this issue.

Sometimes affective-respiratoryseizurescan be divided into 2 types- \"blue\" and \"pale\".

\"Pale\" affective-respiratoryseizuresmore oftenare just a reaction topainin case of a fall, an injection. When you try to feel and count the pulse during such an attack, it disappears for a few seconds. \"Pale\" affective-respiratory attacksAccording to the mechanism of development, they approach fainting. Subsequently, some children with such attacks (paroxysms) develop fainting states.

However, most oftenaffective-respiratory attacks develop according to the “blue” type. They are an expression of dissatisfaction, unfulfilled desire, anger. If you refuse to fulfill the requirements, achieve what you want, or attract attention, the child begins to cry and scream. Intermittent deep breathing stops on inhalation, and slight cyanosis appears. In mild cases, breathing is restored within a few seconds and the child’s condition returns to normal. Such attacks are superficially similar to laryngospasm - a spasm of the muscles of the larynx. Sometimes the attack drags on somewhat, and either a sharp decrease in muscle tone develops - the child goes “limp” in the mother’s arms, or tonic muscle tension occurs and the child arches.

ARPs are accompanied by an increase in vagal tone. With pallid paroxysms, delays in heartbeat (asystole) are sometimes observed, and electroencephalographic (EEG) pathological changes are common in both types of paroxysms. Attacks are observed in the age range from newborn to 5-6 years, although most often observed before the age of 2-3 years.

Attacks can be either rare (once every few months) or frequent, many times a day. The duration of holding your breath can vary from 1-2 seconds to tens of seconds. According to some authors, an attack of ARP can develop into an epileptic seizure.

Affective-respiratory attacks are observed in children who are excitable, irritable, and capricious. They are a type of hysterical attack. More “ordinary” hysteria in young children is characterized bya primitive motor reaction of protest: a child, when his wishes are not fulfilled, falls to the floor in order to achieve his goal: he randomly hits the floor with his arms and legs, screams, cries and demonstrates his indignation and rage in every possible way (a familiar picture, right?). In this "motor storm" of protest, some features of hysterical attacks of older children are revealed.

After 3-4 years of age, a child with breath-holding or hysterical reactions may continue to have hysterical attacks or have other character problems. However, there are ways that can help you prevent the terrible two-year-olds from turning into the terrible twelve-year-olds.

Principles of proper education of a small child with respiratory-affective and hysterical attacks.

Seizure prevention. Attacks of irritation are quite normal for any children, and indeed for people of all ages. We all experience bouts of irritation and rage. We never get rid of them completely. However, as adults, we try to be more restrained when expressing our dissatisfaction. Two-year-old children are more frank and direct. They are simply venting their rage. I think many people have already become familiar with this in practice, right?

Your role as parents of children with hysterical and respiratory-affective attacks is to teach children to control their rage, to help them master the ability to restrain themselves.

In the formation and maintenance of paroxysms (attacks) sometimes plays a certain rolewrongparents' attitude towards the child and his reactions. If a child is protected in every possible way from the slightest upset - everything is allowed to him and all his demands are fulfilled - so long as the child does not get upset - then the consequences of such upbringing for the child’s character can ruin his entire future life.In addition, with such improper upbringing, children with attacks of breath holding may develop hysterical attacks. Proper upbringing in all cases requires a uniform attitude of all family members towardsto the child - so that he does not use family disagreements to satisfy all his desires. It is not advisable to overprotect your child. It is advisable to place the child in preschool institutions (nursery, kindergarten), where attacks usually do not recur. If the appearance of affective-respiratory attacks was a reaction to placement in a nursery or kindergarten, on the contrary, it is necessary to temporarily remove the child from the children's group and re-assign him there only after appropriate preparation with the help of an experienced pediatric neurologist.

The reluctance to follow the child’s lead does not exclude the use of some “flexible” psychological techniques to prevent attacks:

1. Anticipate and avoid flare-ups. Children are more likely to burst into crying and screaming when they are tired, hungry or feel rushed. If you can anticipate such moments in advance, you will be able to circumvent them. You can, for example, avoid the hassle of waiting in line at the cashier at the grocery store by simply not shopping when your child is hungry. A child who gets irritable during the rush to get to nursery during the morning rush hour, when parents are also going to work and an older sibling is going to school, should get up half an hour earlier or, conversely, later - when the house is calmer . Recognize difficult moments in your child's life, and you will be able to prevent attacks of irritation.

2. Switch from the "stop" command to the "forward" command. Young children are more likely to respond to a parent's request to do something, called "go" commands, than to listen to a request to stop doing something. Children do not like the words “no” and “no”. So if your child is screaming and crying, ask him to come to you instead of telling him to stop screaming. In this case, he will be more willing to fulfill the request.

3. Tell the child his emotional state. A two-year-old child may be unable to verbalize (or simply acknowledge) his feelings of rage. In order for him to control his emotions, you should give them a specific name. Without making a judgment about his emotions, try to reflect the feelings the child is experiencing, for example: "Maybe you're angry because you didn't get the cake." Then make it clear to him that, despite his feelings, there are certain limits to his behavior. Tell him, "Even though you're angry, you shouldn't yell and scream in the store." This will help the child understand that there are certain situations in which such behavior is not acceptable.

4. Tell your child the truth about consequences. When talking to young children, it is often helpful to explain the consequences of their behavior. Explain everything very simply: "You have no control over your behavior and we will not allow it. If you continue, you will have to go to your room."

Convulsions during respiratory-affective attacks.

When a child’s consciousness is impaired during the most severe and prolonged affective-respiratory attacks, the attack may be accompanied by convulsions. The cramps are tonic - muscle tension is noted - the body seems to become stiff, sometimes arches. Less commonly, during respiratory-affective attacks, clonic convulsions are observed - in the form of twitching. Clonic convulsions are less common and are then usually observed against the background of tonic convulsions (tonic-clonic convulsions). Cramps may be accompanied by involuntary urination. After convulsions, breathing resumes.Difficulties in differential diagnosis may arise in the presence of seizuresrespiratory-affective paroxysms with epileptic seizures. Moreover, in a certain percentage of casesin children with affective-respiratory convulsionscanEpileptic paroxysms (attacks) also develop in the future. Some neurological diseases can also cause such respiratory affective attacks. In connection with all these reasons, to clarify the nature of paroxysms and prescribe the correct treatment, every child with respiratory-affective attacks should be examined by an experienced pediatric neurologist.

What to do during a breath-holding attack.

If you are one of thoseFor parents whose child holds their breath in a fit of rage, be sure to take a deep breath yourself and then remember this: holding your breath almost never causes harm (youable to hold their breath for some time without harm to their health?).

During an affective-respiratory attack, you can use any influence (blow on the child, pat the cheeks, tickle, etc.) to promote the reflex restoration of breathing.

Intervene early. It is much easier to stop a rage attack when it has just begun than when it is in full swing. Young children can often be distracted. Get them interested in something, say a toy or other form of entertainment. Even such a simple attempt as tickling sometimes brings results.

If the attack drags on and is accompanied by prolonged general relaxation or convulsions, place the child on a flat surface and turn his head to the side so that he does not suffocate if he vomits.

After an attack, reassure and reassure your child if he does not understand what happened. Reemphasize the need for good behavior. Don't back down just because you want to avoid repeat breath-holding episodes.

Examination.

Careful description of the episode is an integral part of treatment. In particular, increased attention should be paid to the circumstances and sequence of events during the attack. This information can serve as an important diagnostic clue. For example, most ARPs are preceded by agitation and crying, which contrasts with epileptic seizures, cardiac disorders, and orthostatic syncope, which often occur without any emotional provocation.

In older children with ARP, additional diagnostic clues may include episodes of urinary incontinence, which often accompany some types of seizures. Also informative are reports about the occurrence of ARP during sleep or complete calm.

Practitioners need to identify information about whether distress is associated with eating or other physical activity, or sensations of chest pain or other physical symptoms. Such findings are suggestive of some other disorder, such as cardiopulmonary (heart and lung) problems.

Genealogical history is another important criterion for assessing a patient. Previous reviews suggest that 20% to 30% of children with childhood APD have family members with similar affective disorders.

If medical history or physical examination indicate epileptic seizures or other central nervous system disorders, video EEG monitoring (preferably recording these conditions) and consultation with a pediatric neurologist are recommended. If a cardiovascular problem is implicated, it would seem appropriate to perform Holter monitoring and consult with a pediatric cardiologist.

TREATMENT

When treating affective-respiratory attacks, it is necessary to take into account that they represent the first manifestation of childhood hysteria and usually occur on a neuropathic basis. Therefore, treatment should be carried out in two directions.

Firstly, family psychotherapy is needed, aimed at correcting upbringing, eliminating indulgent overprotection, normalizing family relationships, etc. It is advisable to place the child in preschool institutions, where attacks usually do not recur. If the appearance of affective-respiratory attacks was a reaction to placement in a nursery or kindergarten, on the contrary, it is necessary to temporarily remove the child from the children's group and re-assign him there only after appropriate preparation.

Secondly, it is necessary to treat neuropathy using a number of drugs that strengthen the nervous system and sedatives. The most beneficial is the use of calcium (calcium gluconate, calcium lactate 0.25-0.5 g per dose), valerian in the form of tincture, as many drops per dose as the child is old, or valerian infusion 3-5 g, multivitamins. In more severe cases, lipocerebrine, phosphrene, glutamic acid, and aminalon are used 2-3 times a day. For very frequent (daily, several times a day) seizures (which may indicate increased excitability of the brain), it is necessary to use small doses of antiepileptic drugs (phenobarbital, hexamidine at night). The use of these drugs is also recommended if paroxysmal activity is detected on EEG studies. As already indicated, some children with affective-respiratory attacks subsequently experience epileptic paroxysms. During an attack of affective-respiratory convulsions, assistance to the child is usually not required. Only with prolonged paroxysm should any influence (spraying with water, patting the cheeks, etc.) promote reflex restoration of breathing.

The older the child becomes, the more important psychotherapy is in the treatment of various paroxysms of neurotic origin. Other types of family psychotherapy are also included - group and collective, as well as individual, aimed at correcting hysterical personality traits.

If a sick child has somatic asthenia, restorative therapy and sanitation of foci of chronic infection are necessary. Sedative therapy is recommended, and in addition to calcium preparations, valerian, bromides, it is often necessary to use tranquilizers - trioxazine, elenium, seduxen (in age-appropriate dosages). Water procedures are useful - pine baths, rubdowns, etc. During the most hysterical attack, no help is required for a sick child.

* You shouldn’t overly patronize and indulge, but you shouldn’t completely neglect your children. Try to prevent and prevent the onset of an attack. Parents usually already imagine situations and the child’s condition that threaten to result in an attack.

* physical exercises and so on without restrictions. But try not to let the child get overexcited. Televisions and computers are prohibited.

* attacks become more frequent in spring and autumn - you need to take vitamins andtake soothing baths, drink teas and exercise.

* there are regularities: The longer the interval between attacks, the greater the likelihood that the next attack will occur later and vice versa. Those. If there has been no attack for 2-3 months, then its likelihood decreases. And if there was an attack, another week later, then the next one could come today.

And of course: be especially attentive to the child’s wishes during this period.

* During an attack, you should not panic, but pay attention to the child: in which direction the head is tilted, at what angle, whether he shakes his head, whether he goes limp or, on the contrary, his body becomes rigid, when this happens, whether his eyes are rolled up and etc. This is necessary so that the doctor can accurately diagnose!!!

* These seizures may be a symptom of epilepsy. But epilepsy is not diagnosed until 5-7 years of age (until a brain tomography can be performedand other examinations. By that time, the vast majority of children "grow out" of this condition. But they still need regular monitoring by a neurologist.

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Affective-respiratory attacks, or paroxysms, seizures (ARP), breath-holding spells, (in common parlance - rolling up) are sudden short-term stops of breathing at the height of inspiration with the inability to exhale, occurring when crying in infants or young children. In this case, the child turns blue or pale to one degree or another. One of the frequently encountered questions regarding emergency care in the practice of pediatricians and child neurologists, this condition is very frightening for parents, so I’ll tell you more about it.

Affective-respiratory attacks (attacks of breath holding) are the earliest manifestation of fainting or hysterical attacks. The word "affect" means a strong, poorly controlled emotion. "Respiratory" is something that has to do with the respiratory system. Attacks usually appear at the end of the first year of life and can continue until 2-3 years of age. Although holding their breath may seem deliberate, children usually do not do it on purpose. This is simply a reflex that occurs when a crying child forcefully exhales almost all the air from his lungs. At this moment he falls silent, his mouth is open, but not a single sound comes from it. Most often, these breath-holding episodes do not last more than 30-60 seconds and pass after the child catches his breath and starts screaming again.

At this time, parents begin to panic, although this, you see, is not the best help for the child. Therefore, I will present all the materials that I managed to collect on this issue.

Sometimes affective-respiratory attacks can be divided into 2 types - “blue” and “pale”.

“Pale” affective-respiratory attacks are most often a reaction to pain from a fall or an injection. When you try to feel and count the pulse during such an attack, it disappears for a few seconds. “Pale” affective-respiratory attacks, according to the mechanism of development, are close to fainting. Subsequently, some children with such attacks (paroxysms) develop fainting states.

However, most often affective-respiratory attacks develop according to the “blue” type. They are an expression of dissatisfaction, unfulfilled desire, anger. If you refuse to fulfill the requirements, achieve what you want, or attract attention, the child begins to cry and scream. Intermittent deep breathing stops on inhalation, and slight cyanosis appears. In mild cases, breathing is restored within a few seconds and the child’s condition returns to normal. Such attacks are superficially similar to laryngospasm - a spasm of the muscles of the larynx. Sometimes the attack drags on somewhat, and either a sharp decrease in muscle tone develops - the child “goes limp” in the mother’s arms, or tonic muscle tension occurs and the child arches.

Affective-respiratory attacks are observed in children who are excitable, irritable, and capricious. They are a type of hysterical attack. More “ordinary” hysteria in young children is characterized by a primitive motor reaction of protest: when desires are not fulfilled, the child falls to the floor in order to achieve his goal: he randomly hits the floor with his arms and legs, screams, cries and demonstrates his indignation and rage in every possible way (a familiar picture, Yes?). This “motor storm” of protest reveals some features of hysterical attacks of older children.

After 3-4 years of age, a child with breath-holding or hysterical reactions may continue to have hysterical attacks or have other character problems. However, there are ways that can help you prevent the dreaded two-year-olds from turning into the dreaded twelve-year-olds.

Principles of proper education of a small child with respiratory-affective and hysterical attacks.

Your role as parents of children with hysterical and respiratory-affective attacks is to teach children to control their rage, to help them master the ability to restrain themselves.

In the formation and maintenance of paroxysms (attacks), the incorrect attitude of parents towards the child and his reactions sometimes plays a certain role. If a child is protected in every possible way from the slightest upset - everything is allowed to him and all his demands are fulfilled - so long as the child does not get upset - then the consequences of such upbringing for the child’s character can ruin his entire future life. In addition, with such improper upbringing, children with attacks of breath holding may develop hysterical attacks. Proper upbringing in all cases provides for a uniform attitude of all family members towards the child - so that he does not use family disagreements to satisfy all his desires. It is not advisable to overprotect your child. It is advisable to place the child in preschool institutions (nursery, kindergarten), where attacks usually do not recur. If the appearance of affective-respiratory attacks was a reaction to placement in a nursery or kindergarten, on the contrary, it is necessary to temporarily remove the child from the children's group and re-assign him there only after appropriate preparation with the help of an experienced pediatric neurologist.

The reluctance to follow the child’s lead does not exclude the use of some “flexible” psychological techniques to prevent attacks:

2. Switch from the stop command to the forward command. Young children are more likely to respond to a parent's request to do something, called "go" commands, than to listen to a request to stop doing something. Children do not like the words “no” and “no”. So if your child is screaming and crying, ask him to come to you instead of telling him to stop screaming. In this case, he will be more willing to fulfill the request.

3. Tell the child his emotional state. A two-year-old child may be unable to verbalize (or simply acknowledge) his feelings of rage. In order for him to control his emotions, you should give them a specific name. Without making a judgment about his emotions, try to reflect the feelings the child is experiencing, for example: “Maybe you are angry because you didn’t get the cake.” Then make it clear to him that, despite his feelings, there are certain limits to his behavior. Tell him, "Even though you're angry, you shouldn't yell and scream in the store." This will help the child understand that there are certain situations in which such behavior is not acceptable.

4. Tell your child the truth about consequences. When talking to young children, it is often helpful to explain the consequences of their behavior. Explain everything very simply: “You are not in control of your behavior and we will not allow it. If you continue, you will have to go to your room.”

Convulsions during respiratory-affective attacks.

When a child’s consciousness is impaired during the most severe and prolonged affective-respiratory attacks, the attack may be accompanied by convulsions. The cramps are tonic - muscle tension is noted - the body seems to become stiff, sometimes arches. Less commonly, during respiratory-affective attacks, clonic convulsions are observed - in the form of twitching. Clonic convulsions are less common and are then usually observed against the background of tonic convulsions (tonic-clonic convulsions). Cramps may be accompanied by involuntary urination. After convulsions, breathing resumes. In the presence of seizures, difficulties may arise in the differential diagnosis of respiratory-affective paroxysms with epileptic seizures. In addition, in a certain percentage of cases, children with affective-respiratory convulsions may subsequently develop epileptic paroxysms (attacks). Some neurological diseases can also cause such respiratory affective attacks. In connection with all these reasons, to clarify the nature of paroxysms and prescribe the correct treatment, every child with respiratory-affective attacks should be examined by an experienced pediatric neurologist.

What to do during a breath-holding attack.

If you are one of those parents whose child holds their breath in a fit of rage, be sure to take a deep breath yourself and then remember this: holding your breath almost never causes harm (you can hold your breath for a while without harm, right?) .

During an affective-respiratory attack, you can use any influence (blow on the child, pat the cheeks, tickle, etc.) to promote the reflex restoration of breathing.

If the attack drags on and is accompanied by prolonged general relaxation or convulsions, place the child on a flat surface and turn his head to the side so that he does not suffocate if he vomits.

Examination.

Treatment of affective-respiratory attacks

At the beginning of an attack, you can sometimes stop it by switching the patient to some type of activity - books, games, a walk. If this cannot be done, it is better not to focus the attention of others on the seizure, leave the child alone, and then the seizure will pass faster.

Let me summarize everything that has been said:

* There is no need to be afraid: children do not die from such attacks (the probability is negligible), - they recover from attacks on their own, even if the parents do nothing (blow, wash with water), but a little later...

* physical exercises and so on without restrictions. But try not to let the child get overexcited. Televisions and computers are prohibited.

* attacks become more frequent in spring and autumn - you need to take vitamins and take soothing baths, drink teas and do exercises.

And of course: be especially attentive to the child’s wishes during this period.

* These seizures may be a symptom of epilepsy. But epilepsy is not diagnosed until 5-7 years of age (until a brain tomography and other examinations cannot be performed. By that time, the vast majority of children “grow out” of this condition. But they still need regular monitoring by a neurologist.

* Of course, there is nothing good about seizures: the nutrition of brain cells stops for a few seconds. Some cells die, but this is invisible to humans and does not affect mental development. But this depends on the frequency of attacks. Of course, if there are attacks almost every day, then the brain suffers greatly.

The most important advice is - don’t be lazy to consult a doctor - a professional will figure it out and prescribe the right action plan for you.

are paroxysms that occur in young children in response to unfavorable exogenous influences. A number of synonyms are known to denote this clinical form: attacks of breath holding, cyanotic or pale syncope, reflex anoxic seizures, non-epileptic vagal attacks, spasm of anger, spasmodic crying, anoxo-asphyxial seizure.

The most successful term used in Russian literature is “affective-respiratory attacks.” It indicates the presence of a provoking moment (affectation), apnea (the basis of pathogenesis) and the involuntary nature of the occurrence of paroxysm.

The frequency of ARP in the pediatric population, according to various sources, is 4-17%. Considering that ARPs are accompanied by apnea and (or) asystole, many authors consider them in the structure of life-threatening conditions. According to some data, ARPs account for about 8% of such conditions.

Causes and mechanisms of occurrence. Affective-respiratory attacks are provoked by paroxysms. To implement ARP, it is necessary to be exposed to factors that cause dissatisfaction, anger, fear or pain. For each child, this can be a special, specific or almost any factor. For example, it is a known fact that ARP in a nine-month-old boy was observed only when he was offered bananas (Oaik ELU. et al., 1963). As a consequence, severe crying occurs, during which hyperventilation of the lungs occurs with hypocapnic cerebral ischemia and a decrease in blood pressure. On exhalation, crying becomes silent, a spasm of the muscles of the larynx and bronchi occurs, leading to apnea, hypoxemia and hypoxia of the brain. When crying and spasm of the respiratory tract, the Valsalva-Weber mechanism is activated, when, due to an increase in intrathoracic pressure, the venous return to the heart decreases, cardiac output and minute volume of blood flow decrease, which leads to hypoperfusion of the cerebral arteries and at the same time to venous stagnation, which, in combination with hypoxemia, leads to to loss of consciousness and/or convulsions.

As a rule, if the mechanism of paroxysm is as described above, diffuse cyanosis of the skin is observed. But sometimes cyanosis is slightly expressed and pallor is noted. The etiopathogenesis of paroxysms occurring with pale skin and with “cyanotic” ARP is different. In the “pale” version of ARP, the provoking factor is often a painful stimulus or fear.

Apnea during paroxysms with blanching is often short-lived, with asystole lasting up to 10 seconds, and sometimes up to 20 seconds. Thus, the main pathogenetic link in ARP is apnea or a combination of apnea and asystole.

Apnea does not have a central origin, since respiratory efforts and movement of the respiratory muscles are noted in the absence of air flow in the upper respiratory tract. There is evidence in the literature that in young children, apnea is caused by laryngeal spasm that occurs during crying due to irritation of receptors and stimulation of the superior laryngeal nerve (Apaz N.0. et al., 1991). Indirect evidence of the importance of age-related hypersensitivity of the superior laryngeal nerve in the occurrence of apnea in ARP is the study of Taulog et al., 1976, which proved that in response to irritation of the superior laryngeal nerve in primate infants, persistent laryngospasm, apnea and death. In adults there is no such reaction.

The possibility of epileptic origin of apnea without combination with general seizures is assumed in the presence of a focus of epileptic activity in the cerebral cortex. The occurrence of asystole with “pale” ARP is associated with increased influence of the vagus nerve on the sinus node of the heart. During the oculocompression test, which is based on the Aschner-Dagnini reflex, almost all children with ARP experience asystole for more than 2 seconds, which is not observed in healthy children (Kabn A. e( a1„ 1994, Loshgoso S., Lehrman R. , 1967).

With preliminary administration of atropine, asystole does not develop. We studied the indicators of cardiointervalograms (CIG) in children with the pale type of ARP. A statistically significant increase in the power of non-respiratory periodic components of the heart rhythm with a period of 6-12 seconds, corresponding to Mayer waves and caused by the action of mechanisms for maintaining blood pressure, was revealed. The data obtained reflect a high degree of tension in the adaptive compensatory mechanisms of maintaining blood pressure in patients in this group.

Gastroesophageal reflux plays a role in the occurrence of cardiorespiratory disorders in some children with ARP. Regurgitation and irritation of esophageal receptors in some patients can lead to breathing problems (spasm of the respiratory tract) and cardiac activity (arrhythmias).

Anemia can contribute to an increase in the degree of hypoxia. Increased hypoxia and cyanosis can develop with arteriovenous shunting during an attack due to an open foramen ovale, ductus botellus, or pulmonary shunt with “cyanotic” ARP. Discussing the reasons for its occurrence, one cannot help but point out the importance of incorrect types of upbringing in families of children with APD. The most characteristic of them are overprotection, education according to the “family idol” type, which contribute to the development of a hysterical reaction, and then neurosis.

There is evidence that ARP is more common in socially disadvantaged families (Bella M.8. et al., 1990). At the same time, indicators of intellectual and mental development in children with ARP do not differ from the norm. It has been suggested that the pathogenesis of some cases of ARP and spasmophilia is similar, which, however, is not confirmed by studying the level of total and ionized blood calcium in patients with ARP (these indicators are within normal limits).

Debut. Paroxysms occur before the age of 6 years. The peak occurs between 6 and 18 months. Rarely, ARP may debut in the neonatal period or after 2 years.

The frequency of ARP in a child can vary from one attack per hour to one per month or less; ARPs tend to increase in frequency during intercurrent diseases; they more often occur in children with poor nutrition, asthenic physique, mobile, and sometimes hypermotor.

Classification issues. We have proposed a division of ARP into the following clinical groups: neurotic and neurosis-like attacks, syncopal (fainting) and “epileptic ARP”.

Clinical manifestations. Neurotic attacks develop in practically healthy, but hyperexcitable children in the presence of defects in upbringing (overprotection in the family, upbringing like a “star, idol”, etc.). Paroxysm should be regarded as a hysterical reaction. Neurosis-like attacks develop against the background of residual organic brain damage when exposed to minor external stimuli.

The provoking factor for neurotic and neurosis-like paroxysms is negative affect (dissatisfaction, anger, resentment, etc.), i.e.

the attack is psychogenic in nature. The child begins to cry, then on inspiration the crying stops, becomes silent, and apnea occurs. “The child is going crazy” - this is how parents often describe this condition.

Before apnea develops, paroxysm can sometimes be prevented by a sharp impact: spraying the child with water, clapping your hands. The sequence of development of clinical manifestations is usually as follows: provocation, then crying, deafening of the cry, cyanosis (“cyanotic” type of attack), loss of consciousness, attempt to inhale, restoration of breathing and consciousness, muscle hypotension, and sometimes sleep.

In rare cases, bilateral tonic tension of the limbs and trunk is observed, sometimes with single symmetrical clonic twitches (“convulsive” manifestations are caused by a high degree of hypoxia during apnea).

Syncopal (fainting) ARPs are provoked mainly by pain (from falling, injections) or fear. In this case, short-term apnea and asystole develop. Cyanosis is not expressed, but pallor of the skin is noted (“pale” version of ARP). Paroxysm develops immediately after pain or other pain.

Impacts at the very beginning of crying. Often, a child does not have time to cry “out loud” before he loses consciousness. It is extremely rare that tonic tension of the limbs and trunk muscles is possible. After the attack, diffuse muscle hypotension, lethargy, and, less often, sleep are recorded.

The term “epileptic ARP” is not entirely correct, since in fact this group of patients suffers from epilepsy, the attacks of which are similar in their external manifestations to ARP. At the same time, diagnosing epilepsy in such cases is difficult, therefore, from a clinical point of view, at the initial stage of diagnosis, such an approach is legitimate, although debatable. According to our observations, verified epileptic seizures are characterized by the development of both cyanosis and skin hyperemia, but not pallor. A combination of apnea (due to spasms of the respiratory muscles) with bradycardia or tachycardia is often observed.

When assessing the duration of loss of consciousness, it was found that loss of consciousness for more than 30 seconds, accompanied by involuntary urination, is most typical for children with “epileptic ARP.” At the same time, it cannot be denied that prolonged loss of consciousness is possible with other types of ARP.

The development of seizures is possible in children with any type of ARP, however, in the group of patients with a high risk of epilepsy, unlike children of other groups, seizures are observed in all cases and are predominantly tonic-clonic in nature. In this group of patients, after an attack, muscle hypotension is most pronounced; post-attack sleep lasts up to several hours.

During the interictal period, in all children with ARP, the ECG does not reveal any specific deviations from the norm. During an attack, tachycardia or normocardia is noted in the “cyanotic” type and asystole in the “pale” type of ARP. When testing with oculocompression in children with the “pale” type

ARP is marked by asystole for more than 2 seconds. When asystole lasts more than 5 seconds, as a rule, the clinical picture of paroxysm develops.

The study of heart rhythm parameters in children with ARP is a highly informative examination method, which allows, in some cases and in the absence of specific changes on the EEG, to differentiate with a high degree of reliability different clinical variants of ARP. When studying the heart rhythm (CHR), 66.4% of children with ARP revealed “increased central influences.” This condition is characterized by high values of relative rhythm variability (10K - 0.82 ± 0.03), a predominance of periodic non-respiratory components of the heart rhythm - 81 (4.9 ± 2.3) and 82 (3.0 ± 0.8), over periodic respiratory components components - 83 (3.8 ± 1.6).

“Increased central influences” occurs in many neurological diseases and serves as a marker of centralization of heart rhythm control (Chasnyk V.G., 1994).

It is important for diagnosis to perform CIG with clinoorthostatic load. According to the indicators M1 (average CC value), 10K, 83, there are stable, that is, persisting in various slices (phases of the clino-orthostatic test), changes in the CIG indicators in children with neurotic and neurosis-like ARP.

The most informative are the increases in the values of indicators M1, 10K and 83. Their informative value, especially 83, is explained by the greater severity of respiratory arrhythmia in children of this group.

With CIG, children from the second group of ARP (“fainting”) reveal a pronounced increase in the power of non-respiratory periodic components of the heart rhythm with a period of 6-12 seconds, corresponding to Mayer waves and caused by the action of mechanisms for maintaining blood pressure. Such characteristics as tt, tach, DH (variation range of CC intervals) are auxiliary and do not carry much information, which is explained by the wide range of fluctuations in the duration of CC intervals in children.

The tension index is also not very informative due to the multimodal distribution of the heart rhythm structure in childhood. On the EEG during the interictal period, specific changes are most often absent.

The exception is children from the group of “epileptic ARP”, in whom regional slow delta, theta or peak wave activity is often recorded on the EEG. During paroxysm, bilateral generalized delta activity with a frequency of 2 Hz, typical of anoxia, occurs. In severe anoxia, a period of activity inhibition is observed (the isoelectric line is recorded) for 5-10 seconds. Then diffuse slow waves of the delta and theta ranges appear. Characteristic is the rapid restoration of the background EEG after an attack.

When studying the level of daily excretion of catecholamines in urine, an increase in the excretion of adrenaline, norepinephrine and dopamine is noted in children with “epileptic ARP”. Similar changes are diagnosed in epilepsy, probably reflecting a generalized defect in catecholamine metabolism (Kovelenova M.V., 1997). In addition to the above studies, it is necessary to conduct a clinical blood test to exclude hypochromic iron deficiency anemia and consult a pediatrician.

Differential diagnosis. It is carried out primarily with epilepsy, as well as with spasmophilia (tetany), cardiogenic syncope.

Principles of treatment. Therapy is carried out jointly by a neurologist, pediatrician, and psychologist. All children with ARP are recommended to be prescribed calcium supplements, pyridoxine, as well as hardening procedures and adaptogens. Prevention of intercurrent diseases contributes to the reduction of ARP. Sedative herbal medicine, group and family psychotherapy are effective. Forming a calm attitude of parents towards the child’s seizures helps to quickly stop them.

In some cases, it should be recommended to enroll the child in kindergarten (in a group setting, ARP, as a rule, does not develop). It is recommended to prescribe nootropics, of which preference is given to pantogam and phenibut, which reduce excitability and prevent asthenia. Pantogam also has slight anticonvulsant activity.

For frequent “pale” ARP, atropine-type drugs are used: belladonna infusion at a dose of 1 drop per year of life per day, atropine - 0.1 mg/kg body weight per day (Orogeon 1^., 1987, Kabin A. e* a1. , 1991, Seberson 1.R., 1978) in a course of 7-10 days.

Anticonvulsant drugs are prescribed only after a diagnosis of epilepsy has been established; the principles of prescription are the same (mainly depending on the form of epilepsy). If there are signs of anemia, it is necessary to prescribe iron supplements and correct nutrition.

Forecast. After 6 years, ARP are observed only in isolated cases. Follow-up studies confirm that although the symptom complex of paroxysm itself disappears, asthenic syndrome is detected in 60-75% of children with ARP, hysterical neurosis in 15-20%, sleep disorders (enuresis, night terrors, sleepwalking, sleep talking) are observed in 10- 15% of children, vegetative-vascular dystonia, fainting - in 10%, migraine in 6-10% of patients.

Problems of maintaining and strengthening the health of children should be considered from the moment of birth. Prevention is the best way to avoid many diseases in later life.

Affective-respiratory attacks in children, only at first glance, are an ordinary problem, to which the less attention you pay, the faster it goes away. You shouldn't think like that. In fact, it is important to know that nervous disorders only get worse over time. Dangerous consequences can manifest themselves in the form of poor performance at school, mental and physical development delays. Somatic disorders may also occur, for example, increased aggregation of erythrocytes, decreased activity of the alveoli in the lung tissue, hypoxia of brain structures, etc.

Affective-respiratory attacks should be prevented whenever possible. With development, first aid should be provided promptly and fully to the baby. The video at the end of this page shows the opinion of an authoritative specialist. He gives convincing explanations of the reasons for the sudden stop of breathing in a child against the background of neurological damage. And the article discusses the etiology, pathogenesis and clinical symptoms of hysterical seizures, methods of their prevention. It tells what parents should do if they see that their child is developing an affective-respiratory attack or convulsions. Before apnea occurs, it is important to try to calm the baby.

What it is? ARP development mechanism

Understanding what breath-holding spells or an affective-respiratory attack is in a child helps to cope with this common problem. The situation is as follows. In common parlance, this condition is called “rolling up.” Roughly speaking, the baby, against the background of strong nervous overexcitation, loses control over his autonomic nervous system. A full-blown hysterical attack develops with all the accompanying symptoms. Affective-respiratory attacks are especially dangerous in infants or newborns, since in the first weeks and months of life there is no clear control over the work of all structures of the central and autonomic nervous system.

Hysteria begins with exposure to a trigger. Negative emotions such as fear, indignation, frustration, irritation, nervousness, pain, etc. can act as an irritant. At the moment when the baby experiences strong negative emotions, he experiences the effect of a primary convulsive reaction. Moreover, it mainly affects the intercostal muscles and the diaphragm. There is a feeling that he cannot breathe air. This causes severe fear, which, against the background of hypercapnia, forms the preconditions for respiratory arrest.

The development of an attack of affective breath-holding can be preceded by aggression or hysteria: the child begins to stomp his feet, scream, demand something, try to hit a parent or others, etc. This is the so-called primary hysterical reaction, which subsequently triggers the mechanism of blocking the respiratory muscles. It is worth understanding that children really cannot inhale and exhale air for completely physiological reasons. And they need help.

Paroxysms can occur in different situations. This distinguishes affective-respiratory syndrome in children from true epilepsy, which always has similar clinical manifestations.

What else is important for parents to know?

The most important thing that modern guardians of a child prone to affective-respiratory breath-holding and convulsive syndrome should know are options and ways to prevent such paroxysms.

Let's start by understanding the definition of APR as a manifestation of insufficient development of the child's autonomic nervous system. By its pathological nature, an affective-respiratory attack in children is a cessation of respiratory movements of the chest due to the lack of innervation (paralysis) of the intercostal muscles and diaphragm. Overexcitation of the nervous system can also turn off the child’s consciousness. This is necessary to quickly restore the reserve of the central nervous system. The lack of oxygen supply to the brain structures makes the baby temporarily forget about the emotional background that led him to such a state. Thus, affective-respiratory syndrome can be considered as a protective reaction of brain structures.

After an attack, the child experiences severe drowsiness and relaxation of the muscular frame of the body. It's best to let him sleep. After awakening, there will be no trace left of the hysterical paroxysm.

According to clinical manifestations, affective-respiratory attacks are divided into white and blue. In the first case, there is a short-term loss of consciousness and severe pallor of the skin. With blue ARP, there is cessation of breathing lasting up to 1 minute, loss of muscle tone and blue discoloration of the nasolabial triangle.

Causes of affective-respiratory attack in children

Many pediatricians still recognize only one cause of affective-respiratory attack in children, and this is typical hysteria. However, in reality everything is much more complicated. There are multiple or complex causes of an affective-respiratory attack, and among them there is indeed an excessive or hysterical reaction of the autonomic and central nervous system to the influence of a negative traumatic factor. But this is far from the only factor that provokes ARP.

So, pathogenetic influence factors include:

weakness of the autonomic nervous system, such children will suffer from vegetative-vascular dystonia in the future;
consequences of severe birth trauma (cerebral hypoxia, low assessment of the condition of the non-born on the Apgar scale);
violation of the daily routine and regular lack of sleep (often found in children attending kindergarten and parents going to bed late);
insufficient amounts of B vitamins and some important amino acids in the diet;
the presence of serious chronic somatic pathologies;
increased convulsive readiness;
increased muscle tone;
disruption of the development of cerebral blood vessels of the neck;
thyroid diseases;
adenoiditis, tonsillitis and other chronic pathologies of the upper respiratory tract that complicate the process of physiological breathing.

To prevent attacks with breath holding, it is important to exclude, if possible, all possible causes of this pathological condition. It is important for parents to remember that affective respiratory syndrome can cause sudden death. And in the future, this condition can lead to serious neurological disorders, including epilepsy.

Classification of attacks depending on clinical manifestations

The modern classification of attacks of affective-respiratory arrest with convulsive syndrome implies subdividing them into 4 distinct types.

Depending on the clinical manifestations of pathological spasm of the respiratory muscles, the following types of attacks are distinguished:

blue ARP begins with hysteria, followed by a sharp deep breath and then asphyxia (lack of breathing) sets in, hyperemia of the skin quickly gives way to cyanosis, the child loses muscle tone and becomes limp, and may lose consciousness;
white ARP is more complicated, with obligatory loss of consciousness and the rapid onset of characteristic pallor of the skin of the face, neck and chest;
a simple type of ARP occurs without hypercapnia and hypoxia, the breath holding is short-term and does not exceed 20 seconds;
a complicated type of ARP occurs with severe hypoxia of the brain (if there is no breathing for more than 60 seconds), accompanied by involuntary urination and convulsions in the lower and upper extremities.

In all 4 types, respiratory activity is completely restored on its own. Emergency medical care may be required only in the case of a complicated version of the development of ARP. But frequent attacks always lead to disruption of social adaptation. They can provoke a delay in the mental and mental development of the child. Therefore, it is important to carry out psychocorrection in a timely manner and do everything necessary to prevent affective-respiratory attacks in children.

Symptoms and clinical picture

It is important to understand that the clinical picture of ARP may resemble an epileptic attack. Therefore, it is important to conduct a full examination to exclude epilepsy. Symptoms may include the following:

the increase in hysterical reaction to external negative influence occurs within 2-4 minutes;
with a gradual deepening of hysteria, the child experiences overexcitation of the cerebral cortex;
control over the muscles is lost - at this moment you can see stopping breathing and loss of tone of the whole body;
the baby seems to go limp, stops breathing and slowly slides to the floor;
the skin of the face, neck and chest begins to change color - at first they turn sharply red, then, depending on the type of attack, they turn white or blue;
a short-term loss of consciousness may occur;
After a few seconds, the child comes to his senses, abruptly stops crying and begins to breathe fully.

In the complicated type, the clinical picture is supplemented by clonic convulsions. From the outside they look like slight twitching of the arms and legs of an unconscious baby. The picture is very difficult for the parents of the injured child to perceive. Usually in such situations, parents begin to panic. And this only makes things worse. Why? Let's tell you further.

Diagnosis and differences from epilepsy

It is important to understand that affective-respiratory convulsions are only superficially similar to the manifestation of epilepsy. However, to exclude such a condition, it is not enough to know the main differences. Diagnosis necessarily includes an EEG (electroencephalogram of the brain). This examination shows the absence of a focus of excitation in the cortex and brain structures in ARP and its presence in epilepsy. Therefore, this examination is definitely worthwhile. At least to calm myself down. And treat the baby more correctly.

It is also important to exclude hysteria. It is based on an attack of aggression, but it does not provoke respiratory arrest and loss of consciousness. If a child has a hysterical attack, you should maintain your own calm and not show your child that this behavior greatly upsets you. Under no circumstances should a child be allowed to achieve his goals with such hysterical attacks. Otherwise, such a style of behavior will be fixed at a reflex level. You will receive regular affective-respiratory attacks at the slightest reason for the child’s negative perception of reality.

The distinctive features of epileptic seizures and affective-respiratory attacks are as follows:

Various circumstances lead to ARP, and epilepsy manifests itself without external causes;
ARP always develops differently, but epileptic seizures are always the same;
In children under 4 years of age, epileptic seizures account for no more than 2% of the total number of such disorders;
in children over 5 years of age, attacks of affective-respiratory disorder are diagnosed only in 1% of the total number of cases;
with ARP, valerian, motherwort and nootropic treatment help;
in case of a true epileptic seizure, it is useless to give sedatives;
There are significant pathological changes in the EEG only in epilepsy.

If the baby has an attack, then it is necessary to show him to the doctor within the next 1.5 hours. These manifestations can be the result of very dangerous diseases. Only in a medical institution can an ECG of the heart and an ultrasound of internal organs be done to exclude heart defects, pulmonary vein embolism and other dangerous conditions; spirography, an X-ray of the lungs, and examination of the trachea for the presence of foreign bodies may also be required.

You may also need to consult a pulmonologist, neurologist and allergist. After collecting all the necessary information, the doctor will be able to make an accurate diagnosis and prescribe adequate treatment.

Providing first aid to a child with ARP

You need to know what to do when such symptoms appear, and what you should avoid categorically. Providing first aid to a child when symptoms of ARP appear should begin with clearing the airways. You can take the baby out into the fresh air. You need to unfasten the top buttons and remove the pressure on your neck.

It is important not to get confused or panic. Try to maintain your composure and smile. This will help the baby recover faster. Try patting him on the cheeks or lightly tickling him. If you have ammonia on hand, give it a sniff. Just don't bring it too close to the baby's face.

In case of loss of consciousness, it is important to create conditions to prevent tongue retraction. To do this, place the child on a flat surface and turn his head to the side. And here you should call an ambulance.

Treatment of affective-respiratory attacks in children

Therapy begins with behavior correction and psychological work with parents. Such conditions most often occur in children raised in families where parents do not follow the rules of communication with them.

Treatment of affective-respiratory attacks begins with a consultation with a neurologist. A specialist can give a referral to a psychologist to correct the mental state of both the baby and his parents. Drug therapy may then be prescribed. But, as a rule, it does not give any special results. It is much more important to take the following steps:

normalize the child’s daily routine:
develop a special diet containing all vitamins, minerals and amino acids;
exclude, if possible, traumatic factors;
teach your child to listen to his parents and compromise with them.

Effective treatment for respiratory attacks in children may include visiting a chiropractor. Acupuncture and reflexology, massage and therapeutic exercises will help restore the functioning of the autonomic central nervous system.

If the nervous system is hyperexcitable, it makes sense to carry out a course of treatment with nootropic drugs and sedatives. But this can only be done on the recommendation of a doctor and strict adherence to the recommended dosage.

See why affective-respiratory attacks develop in children - the video presents the opinion of a specialist in child neurology:

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