Prolonged generalized epileptic seizures triggered by breath-holding spells

We report a 3-year-old female with anoxic-epileptic seizures. Beginning at 11 months of age, she had repeated breath-holding spells with transition in to generalized tonic-clonic seizures or status epilepticus. Interictal elec troencephalography exhibited no abnormalities. A multidisciplinary diagnost ic approach revealed a severely disturbed mother-daughter relationship that was the trigger of the breath-holding spells. Psychotherapy for the mother and daughter led to cessation of the breath-holding spells and, consequent ly, of the anoxic-epileptic seizures. Her further development was largely n ormal. We discuss the etiology and treatment of anoxic-epileptic seizures. This case is the first reported case of anoxic epileptic seizures that resp onded to psychologic rather than antiepileptic treatment. We advocate an in itial psychologic assessment to help determine the appropriate treatment in children with recurrent anoxic-epileptic seizures. (C) 2000 by Elsevier Sc ience Inc. All rights reserved.