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Death Following Breath Holding in an Adolescent

Am J Dis Child. 1981;135(2):180-181. doi:10.1001/archpedi.1981.02130260068021.
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Breath holding is not uncommon in infancy following a startle, injury, or punishment. This reaction generally does not persist beyond the age of 6 years, and the outlook for normal development is excellent.1

In 1951, Howard et al2 described voluntary breath holding in older children and adults, a practice we still find present in school-aged children.2 In this maneuver, a period of hyperventilation is followed by a Valsalva maneuver (forced expiration against a closed glottis) and the victim responds with brief unconsciousness. Howard et al warn against the risk of "injury during falling" and report the production of a convulsion in one volunteer during this procedure.

Recently, we observed a 12-year-old boy who died following a modified breath-holding spell. We report the case to document the risk involved, as well as to learn if similar incidents have been recorded by others. Report of a Case.—A 12-year-old


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