Affective-respiratory seizures, or ARPs, mean seizures, against the background of which, after the action of an excessive physical or emotional stimulus for the nervous system in children, breathing is delayed and short-term apnea appears. Sometimes convulsions with loss of consciousness can join this condition. Such attacks pass, as a rule, without any consequences, but require mandatory observation by a neurologist and cardiologist.
General pathology information
An affective respiratory attack can occur in children aged six months to two years. Sometimes such attacks appear in children who are three years old. Newborns, as a rule, do not suffer from this phenomenon, until six months of such attacks there are almost no cases due to the immaturity of the nervous system. Later with age, children develop this ailment. The frequency of affective and respiratory attacks in children is five percent of the total number of all babies. Such children require special attention in the upbringing, since a childhood attack is equivalent to a hysterical seizure in adults.
Causes of Attacks
The leading causes are hereditary factors. There are children who are excitable from birth, and there are features of the nature of the parents who can inadvertently provoke such symptoms. Parents of such babies also experienced something similar in their time. The causes of affective respiratory attacks are as follows:
- Complete disregard for adult child requirements.
- Lack of parental attention.
- The appearance of fright, agitation, fatigue, or stress.
- Overload of impressions.
- All kinds of falls along with injuries and burns.
- Frequent family scandals.
- Forced communication with a relative unpleasant for the child.
Adults should be aware that a child can react in such an unconscious way, and not in any way intentionally. This may be a temporary and abnormal physiological reaction, which the child is usually not controlled. The fact that the baby has such reactions is to blame especially for his nervous system, which can no longer be changed. Some children are born like this, and immediately an early age serves as the beginning of all such manifestations. Such affective and respiratory attacks in children need to be corrected with the help of pedagogical measures in order to avoid problems with the character at an older age.
Symptoms
This syndrome is divided into four types by pediatricians. The classification in this case is as follows:
- A simple version of the syndrome. Against this background, respiratory arrest occurs at the end of exhalation. Often, such a syndrome develops immediately after the baby is dissatisfied or injured. In this case, breathing can be restored independently, and the saturation of blood with oxygen does not decrease in any way.
- Blue type. This option usually occurs after pain reactions. After crying, a forced expiration occurs, while the child’s mouth will be open, but no sounds will follow. Rolling eyes will be observed along with respiratory arrest. At the same time, the kids blush brightly, then turn blue, and then go limp, sometimes they can even pass out. Some children regain consciousness immediately after breathing, while others may fall asleep immediately for an hour or two. In that case, if you record the encephalography during an attack, then no changes will be noticed on it. The classification of affective respiratory attacks does not end there.
- White type. With this option, the child will almost not cry, but will suddenly turn pale and immediately lose consciousness. Then he will have a dream, after which there will be no consequences. A seizure focus on encephalography will not be detected.
- Complicated type. This option may begin as one of the previous ones, but then paroxysms, which are similar to epileptic seizures that can be accompanied by urinary incontinence, usually join. A similar condition in a child can pose a serious danger to all tissues as a result of brain hypoxia and oxygen starvation.
Such convulsions do not represent any danger to the life of the child. But if available, a neurologist consultation is considered mandatory in order to limit such manifestations from more serious cases. Holding your breath during seizures occurs for a period of several seconds to three minutes, it can be very difficult for parents to maintain self-control against the background of all this. The average respiratory arrest in children is sixty seconds.
The mechanism of development of pathology
I must say that such seizures look frightening, especially if the affective and respiratory attack in the baby has developed. As soon as the child stops breathing, the intake of oxygen in his body instantly stops. In the event that the breath-holding continues for a long time, then the muscle tone reflexively decreases, the child “becomes limp”. This serves as a response to the development of acute oxygen deficiency, which affects the brain. In the brain, a process of protective inhibition occurs, its work begins to be rebuilt in order to consume as little oxygen as possible. As a result, there comes a rolling of the eyes, very frightening to the parents.
In the case of continued respiratory arrest during an affective respiratory attack (code ICD-10 - R06 “Abnormal breathing”), the muscles of the body sharply increase their tone, and the baby’s body tenses and bends, clinical cramps in the form of rhythmic twitches of the trunk and limbs can occur.
All this leads to the accumulation of carbon dioxide in the body, that is, directly to hypercapnia. Muscle spasms of the larynx are reflexively reduced from this, and the child takes a breath. Inhalation is usually done with crying, after which the child begins to breathe well and calmly. In practice, seizures usually occur extremely rarely. After apnea, children immediately stop rolling their eyes, and for some, breathing can be restored after the stage of limp.
Emotions and breathing
These affective respiratory attacks are not in vain called. Young children so express their anger with displeasure, if something is not done the way they want. This is a real affect, which is an emotional fit. Such children are initially distinguished by increased emotional excitability, and in addition, moodiness.
In that case, if you leave these character traits without proper attention, then at older ages children make real hysterical seizures when they are denied something. For example, they begin to fall to the floor, yelling at the entire store or kindergarten, stamping their feet. Of course, they calm down only when, finally, they get what they want.
The causes of this behavior on the part of children are twofold. On the one hand, they are distinguished by hereditary features of the nervous system, and on the other, their parents are not able to treat them in such a way that they can smooth out all the corners of the complex nature of the child.
What should be done during seizures?
First of all, parents should not panic. The emotional state of those around is always transmitted to the baby, and if confusion with fear is warmed up, it will only get worse. It will not be superfluous to hold our breath for a short while. This will allow you to feel that nothing bad will happen to the baby from a temporary delay in respiratory functions. You can also blow the baby on the nose, pat it on the cheeks and tickle it. Any such action will help the child recover much faster to breathe again.
With prolonged seizures, especially those accompanied by convulsions, you should put the baby on a flat bed, and then turn his head to the side. So he will not be able to choke on the vomit if he vomits. It is recommended to spray cold water on the baby, then wipe the face and gently tickle.
It should be noted that when mothers and fathers tear their hair during attacks, they make the condition of children even worse. After seizures, the baby should be given rest. You can’t wake him if he suddenly falls asleep. It is important to remain calm after attacks, talking quietly. The main thing is not to make noise. In the presence of a nervous situation, seizures can be repeated.
For any seizures accompanied by convulsions, you should definitely consult a neurologist. Only a doctor can distinguish an affective respiratory attack from epilepsy or other neurological disorders. Thus, you need to arrange a consultation with your doctor if something like this happens for the first time. The doctor must determine if the child has a disease or is it an affective reaction. In the event that the attack does not occur for the first time, and the disease as such is absent, measures must be taken with respect to the upbringing of the child.
When something similar happens with a child for the first time, you need to call a doctor. This is especially necessary against the background of seizures. The pediatrician will be able to assess the severity of the condition and say whether the child needs hospitalization. After all, parents can not always keep track of the baby in full. In addition, the effects of brain injuries, various poisonings and all kinds of acute diseases are manifested.
What should parents do with an affective respiratory attack? Komarovsky advises the following.
Rules for Parents
The task of parents is, first of all, to teach the child to manage anger and rage in such a way that these feelings do not interfere with the lives of others. Discontent along with anger and rage are natural human emotions, of course, no one is immune from such. But the child must know the boundaries that he is not entitled to cross. Here's what you need:
- Parents should be united in requirements. There is nothing worse for a baby when one parent allows him something, and the other, on the contrary, forbids him. A child can grow up like a manipulator, from which absolutely everyone will suffer.
- Children should be identified in the children's team. In such a society, a hierarchy is built in a competent way, against which children learn to know their place. In the event that seizures appear on the way to the garden, a consultation with a child psychologist is required.
- It is necessary to avoid situations against which the occurrence of seizures is most likely. For example, morning rush along with a queue in a supermarket and a long walk on an empty stomach and so on can be provocateurs. It is necessary to plan the day of the child so that he is well-fed and sufficiently rested.
- Parents should be able to switch attention. When a child cries, you need to distract him with something, such as a passing car, a butterfly, and so on. The main thing is not to let the emotional reaction gain momentum.
- Every child should clearly know the boundaries. When he probably knows that he will not receive the toy from either his grandmother or anyone else, even after a desperate cry, he will still calm down on his own.
- All the moments that occur with the baby need to be spoken calmly, without raising your voice. It is important for children to explain why their crying is useless. And the most sensitive thing is to add that mom and dad love him, that he is good, but there are rules that simply cannot be broken by anyone.
How is the diagnosis made?
How is an affective respiratory attack diagnosed? First, the doctor should thoroughly examine the child. If necessary, a neurosonography and an electrocardiogram are prescribed. The diagnosis of affective respiratory attacks is made only when no organic disorders are detected.
Treatment
Treatment, as a rule, begins with the proper organization of the daily routine of the child. The recommendations in this case are simple, ranging from diet to walks, activities according to age, and so on. It should be noted that without the implementation of these recommendations, no treatment is likely to help, since a measured and orderly lifestyle is the main requirement and what the children's body really needs.
Some parents need classes with family psychologists to learn to understand their children. Drug therapy is extremely rare. In such cases, doctors are most often limited to prescribing neuroprotective drugs and nootropic drugs to children, and in addition, vitamins. It should be emphasized that the best prevention is a calm, and at the same time friendly atmosphere in the family circle without any quarrels and a long clarification of relations. As part of the treatment, the doctor can give a referral to a psychologist in order to correct the mental state of the child. It is very important to take the following steps during therapy:
- Develop a special nutritious diet for the child, rich in vitamins, amino acids and minerals.
- A complete exclusion of traumatic factors is required.
- The child needs to be taught to listen to parents. In addition, it is important to make sure that he needs to compromise with his mom and dad.
Effective treatment of affective and respiratory attacks in adult children also involves acupuncture along with reflexology, massages and therapeutic exercises. All these measures will certainly help restore the healthy functioning of the autonomic nervous system. But the most important thing is to be able to make sure that the family has a cozy and friendly atmosphere.
What are the consequences of affective respiratory attacks?
What are the implications?
Such attacks, as a rule, have no negative consequences, they are most often short-lived, the state of the child’s health does not deteriorate and does not have any effect on the functioning of organs and systems in the future. With a prolonged attack, a prolonged respiratory failure may occur for several minutes, and if there are severe comorbidities, cardiac activity may cease, and coma may occur. The literature describes lethal outcomes (only a few) due to aspiration.