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

Step 1: Know the two types of breath-holding spells.
Breath-holding spells happen in young children and come in two forms. The cyanotic type starts with the child crying hard after being upset, in pain, or after a minor trauma, then the child holds its breath, stops breathing, and turns blue (cyanosed). The pallid type is triggered mostly by a minor injury or a sudden fright, and here the child does not cry much, but goes suddenly pale and limp because of a brief vagus-driven slowing or pause of the heart.

Step 2: Check statement 1.
Both types can be set off by a minor trauma, such as a small bump or fall, so statement 1 is correct.

Step 3: Check statement 2.
The cyanotic type matches exactly: the child stops breathing and turns blue. So statement 2 is correct.

Step 4: Check statement 3.
The pallid type matches this: the child goes suddenly pale and floppy. So statement 3 is correct too.

Step 5: Check statement 4.
Breath-holding spells are strongly linked to iron deficiency anemia, and giving iron, not zinc, is what has been shown to reduce how often the spells happen. Zinc supplementation is not the treatment used for this link, so statement 4 is not correct.

Step 6: Final answer.
Statements 1, 2 and 3 are correct, while statement 4 is wrong.
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