Avtor/Urednik		Perković-Benedik, Mirjana
Naslov		Primerjava diagnostičnih postopkov za ugotavljanje pretirane vagusne vzdraženosti pri otrocih z afektnimi napadi
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Medicinska fakulteta
Leto izdaje		2003
Obseg		str. 48
Jezik		slo
Abstrakt		The breath-holding spells are a common cause for a loss of consciousness during the early childhood. The episodes of breath-holding spells are involuntary and reflexive and usually occur after a provocation that causes anger, frustration or reaction to pain. There appear to be two clinical forms: the pallid type and the cyanotic type. Both differ also according to the underlying pathophysiologic mechanisms. At the beginning of the spell a child usually cries or wants to cry, suddenly becomes silent and holds breath in expiration. The color of skin changes: in pallid type becomes pale and in cyanotic type cyanosis occurs early in the episode. After that the child may lose consciousness. Observation of children during the pallid breath-holding spells revealed marked bradycardia or asystole. An excessive vagal tone has been implicated as a cause of pallid breath-holding spells. The pathophysiology of the cyanotic breath-holding spells is complex and not completely understood. Results of some investigations suggest that there is also an autonomic dysregulation in children with cyanotic breath-holding spells. Ocular compression that triggers the oculocardiac reflex is used to evaluate vagal tone in children with breath-holding spells. In our laboratory the treshold value for vagal overactivity has not been established yet. In that purpose we performed a retrospective study. We reviewed 190 oculocardiac reflexes done during 5-year period. We found out that asystole of 6 seconds duration or more indicate a vagal overactivity in children younger than seven years old in our laboratory (95% of children with pallid breathholding spells have an asystole of 6 seconds duration or more). In a prospective part of the study we compared responses of the oculocardiac reflex and the cold face test. (Abstract truncated at 2000 characters).
Deskriptorji		AFFECTIVE DISORDERS VAGUS NERVE REFLEX, OCULOCARDIAC BRADYCARDIA HEART ARREST CHILD COLD CYANOSIS ELECTROCARDIOGRAPHY ELECTROENCEPHALOGRAPHY HEART RATE RETROSPECTIVE STUDIES