Q:

You are evaluating a 5-year-old child with breath holding spells, the history given includes pallor with abnormal limb movement lasted for 5 minutes followed by sleep

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You are evaluating a 5-year-old child with breath holding spells, the history given includes pallor with abnormal limb movement lasted for 5 minutes followed by sleep.All the following are true responses/advices EXCEPT


  1. reassurance, behavioral instruction to parents and follow up
  2. order MRI brain
  3. rder an ECG
  4. order an EEG
  5. neurological consultation

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(A). in non-classical type of breath holding spells; medical conditions to consider should include seizures, Chiari crisis, dysautonomia, cardiac arrhythmias (as prolonged QT interval), and central nervous system lesions. So all the above optional investigations are justifiabl

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