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Breath-holding spells after endoscopic third ventriculostomy in a post-ventriculoperitoneal shunted patient

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Abstract

Breath-holding spells (BHS) are commonly observed in children as a result of an autonomic nervous system disorder triggered by crying, emotional distress, or pain. There are several types of BHS and cyanotic type is one of them. We encountered a case of 3-year-old girl who presented with a delayed adaptation period and BHS 2 weeks after an endoscopic third ventriculostomy (ETV). She experienced severe headache due to increased intracranial pressure (ICP) during the delayed adaptation period, which may have contributed to the onset of BHS. Management of BHS warrants treatment of the symptoms and removal of the causative factors; in our case, intensive pain control and resolution of the increased ICP after the adaptation period were effective. While BHS are usually described as a benign condition that improves spontaneously, we highlighted the importance of recognizing and monitoring atypical symptoms such as BHS in pediatric cases.

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Acknowledgements

We thank the staff of the Department of Neurosurgery at Tokyo Women’s Medical University for their guidance and assistance in preparing this paper. Documented informed consent was obtained from patient’s guardians.

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Authors and Affiliations

  1. Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan

    Kentaro Chiba, Yasuo Aihara & Takakazu Kawamata

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  1. Kentaro Chiba
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  2. Yasuo Aihara
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  3. Takakazu Kawamata
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Correspondence to Yasuo Aihara.

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Chiba, K., Aihara, Y. & Kawamata, T. Breath-holding spells after endoscopic third ventriculostomy in a post-ventriculoperitoneal shunted patient. Childs Nerv Syst 38, 813–816 (2022). https://doi.org/10.1007/s00381-021-05247-z

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  • DOI: https://doi.org/10.1007/s00381-021-05247-z

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