Affiliation:
1. Ghent University Hospital
Abstract
Abstract
1. Purpose
Reflex anoxic seizures are an overreaction of the vagal system, resulting in bradycardia or brief cardiac arrest. Because of self-limiting character of the spells with no complications on short or long term, treatment is only necessary in case of frequent spells or severe clinical presentation. Treatment options are medication such as atropine or the implantation of a cardiac pacemaker, with the latter being invasive and entailing risk for important complications. We investigated atropine treatment and aimed to examine if pacemaker placement can be avoided.
2. Methods
We retrospectively reviewed patients treated in our center for severe reflex anoxic seizures with atropine sulphate from January 2017 until May 2023, and compared our results to those in the literature.
3. Results
In our population, 100% of the patients reported adequate symptom management after atropine treatment, with complete resolution in 10%. Minor side effects were reported in 70%, with need for change of treatment in one patient (10%). Severe complications were not reported, unlike up to 40% of permanent or severe complications after pacemaker placement.
4. Discussion
Atropine is a safe and efficient treatment to manage the symptoms, with similar success rate to pacemaker implantation. However, pacemaker implantation entails a substantial risk for complications. This might be considered redundant for a benign and temporary condition, when other efficient treatment options are possible.
Publisher
Research Square Platform LLC
Reference27 articles.
1. Atropine treatment of reflex anoxic seizures;McWilliam RS;Archives of Disease in Childhood,1984
2. Breningstall, G., Breath-Holding Spells. Pediatric Neurology, 1996. 14: p. 91–97.
3. Reflex asytolic syncope;Whitehouse WP;pediatrics and child health,2013
4. Desaturation During Cry in the Neonatal Period;Salomon C;Global pediatric health,2018
5. Management of reflex anoxic seizures in children;Iyer A;Archives of disease in childhood,2013