RT Journal Article SR Electronic T1 Breath-holding spells in infants JF Canadian Family Physician JO Can Fam Physician FD The College of Family Physicians of Canada SP 149 OP 150 VO 61 IS 2 A1 Ran D. Goldman YR 2015 UL http://www.cfp.ca/content/61/2/149.abstract AB Question I have children in my clinic who experience seizurelike episodes in which they cry and hold their breath to the point of cyanosis and loss of consciousness. Their examination or investigation findings are normal and referral to a pediatric specialist results in no further investigation. Are breath-holding spells common, and what type of investigation is needed? Answer A breath-holding spell is a benign paroxysmal nonepileptic disorder occurring in healthy children 6 to 48 months of age. The episodes start with a provocation such as emotional upset or minor injury, and might progress to breath holding, cyanosis, and syncope. The episodes are extremely frightening to watch but have benign consequences. Once a clinical diagnosis is made, it is recommended to conduct an electrocardiogram and to rule out anemia, but no further investigation or referral is warranted.