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      Crisis cerebrales anóxicas reflejas pálidas (vagales). I: Aspectos clínicos

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          Abstract

          Se estudian 200 niños con manifestaciones clínicas sugestivas de crisis cerebrales anóxicas reflejas pálidas con resultados positivos a la compresión ocular. La edad promedio de comienzo de las crisis se sitúa entre 5 y 6 años. El 21 % de los pacientes refirió antecedentes familiares de crisis vagales. Los factores precipitantes se reconocieron en el 61 % de los niños. La sudación, frialdad de la piel, pérdida de la conciencia e hipertonía generalizada constituyeron las manifestaciones clínicas referidas más frecuentes. El 1 % de los pacientes recibió tratamiento antiepiléptico previo.

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          Most cited references16

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          Epilepsy in children

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            Reflex anoxic seizures ('white breath-holding'): nonepileptic vagal attacks.

            From clinical history 58 children were diagnosed as having reflex anoxic seizures secondary to provoked cardioinhibition (also known as white breath-holding attacks). Before referral, these seizures were commonly misdiagnosed as epileptic either because the provocation was ignored, not recognised, or was a febrile illness, or because there was no crying, no obvious breath-holding, little cyanosis, and often no pallor to suggest syncope and cerebral ischaemia. The duration of cardiac asystole after ocular compression was measured in these children and in 60 additional children with other paroxysmal disorders. In 45 (78%) of the 58 with reflex anoxic seizures asystole was 2 seconds or over, and in 32 (55%) it was 4 seconds or greater, an abnormal response. Review of the literature supports the concept that these seizures result from vagal-mediated reflex cardiac arrest which can if necessary be prevented by atropine. The simple name 'vagal attack' is proposed. Ocular compression under EEG and ECG control supports the clinical diagnosis if asystole and/or an anoxic seizure is induced; the procedure described is safe and should be routine in seizure or syncope evaluation, when a meticulous history still leaves room for doubt.
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              The diagnoses and treatment of convulsive disorders in children

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                Author and article information

                Journal
                ped
                Revista Cubana de Pediatría
                Rev Cubana Pediatr
                Centro Nacional de Información de Ciencias Médicas; Editorial Ciencias Médicas (La Habana, , Cuba )
                0034-7531
                1561-3119
                April 1995
                : 67
                : 1
                Affiliations
                [01] Ciudad de La Habana orgnameHospital Pediátrico Docente William Soler Cuba
                Article
                S0034-75311995000100008 S0034-7531(95)06700108
                95aafe28-c464-49b1-bd8d-f77129b8fe4f

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 21 November 1994
                : 23 November 1994
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 0
                Product

                SciELO Cuba

                Categories
                ARTÍCULOS ORIGINALES

                ANOXIA CEREBRAL
                ANOXIA CEREBRAL

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