Question

Consider the following statements about breath-holding spells in children:

1. They are usually preceded by minor trauma.
2. The child stops breathing and becomes cyanosed.
3. The child suddenly becomes pale and limp.
4. Frequency becomes less with zinc supplementation.

Which of the above statements are correct?

• A. 1, 2 and 3
• B. 1 and 2
• C. 2, 3 and 4
• D. 1, 3 and 4

Hint:

Recall that breath-holding spells come in a blue type and a pale type, and think about which mineral deficiency they are linked to.

Answer 1

The Correct Option is A

Breath-holding spells are a common toddler problem with two clear patterns, and the question gives four claims about them that need to be checked one by one.

1. Preceded by minor trauma: True. A small fall, bump, or fright is a common trigger for both the cyanotic and the pallid type of spell.
2. Child stops breathing and is cyanosed: True. This describes the cyanotic form, where the child cries hard, holds the breath at the end of expiration, and turns blue.
3. Child becomes suddenly pale and limp: True. This describes the pallid form, where a brief vagal-mediated slowing of the heart makes the child go white and floppy, often with little or no crying first.
4. Frequency becomes less on zinc supplementation: False. The known link is with iron deficiency anemia, and it is iron therapy that has been shown to cut down how often these spells occur, not zinc.

Since the first three claims match the known features of breath-holding spells and the fourth does not, the correct combination is 1, 2 and 3.

Let's summarize:

• Breath-holding spells have a cyanotic form (breath-holding and blueness) and a pallid form (sudden pallor and limpness).
• Minor trauma or fright is a common trigger for both forms.
• Iron deficiency is the linked nutritional cause, and iron therapy, not zinc, reduces spell frequency.

So the correct answer is statements 1, 2 and 3.