<unk>  anoxic seizures are a particular type of anoxic seizure, most commonly seen in young children in whom an anoxic seizure or<unk>  is provoked or precipitated by a noxious stimulus (hence<unk> ”). Various precipitants have been identified, but the most common is an unexpected bump to the head. Breath-holding attacks have been recognized for centuries. However, it is only relatively recently that their pathophysiology has begun to be understood, and in consequence, their separation from<unk>  anoxic seizures has been recognized. Indeed, the distinction between the two may not be complete. Although minor bumps to the head are reported as the most common precipitants to<unk>  anoxic seizures, many other stimuli may also be involved. Doctors emphasized the importance of minor injuries and sudden fright. They noted that occipital blows to the head appeared to be particularly provocative. Pain, especially from emotion (surprise, fear, annoyance, frustration, and excitement), crying, and fever were provocative factors. Fever was reported as a provocative factor in 14% of cases. Some cases of fever-induced<unk>  anoxic seizures are likely to be misdiagnosed as febrile (epileptic) seizures, as has been emphasized by a number of authors. Many, if not most, cases of venipuncture fits are<unk>  anoxic seizures. When one considers the vast range of situations in which a child (or adult) can be surprised, frightened, upset, or merely excited, it is easy to understand how<unk>  anoxic seizures can occur in special settings, such as bathing and water immersion; in the anesthetic room; when witnessing “blood and gore”; at the dentist office, school, place of worship, or the hairdresser's; and whilst watching television. The precipitants and the manifestations of<unk>  anoxic seizures may change with age. Hence, in unsteady toddlers, minor bumps to the head are likely to predominate, whilst in the older child, adolescent and adult factors such as the sight of blood or venipuncture are likely to be more relevant. The adult physician is likely to classify such events as vasovagal<unk> s rather than as<unk>  anoxic seizures and indeed progression through<unk>  anoxic seizures to vasovagal<unk>  is recognized. In this regard, note that beyond the toddler stage, children with<unk>  anoxic seizures may report out-of-body experiences with a dream-like quality. Types Numerous types have been described. The best known, if not necessarily the best understood, is the “simple faint” or vasovagal<unk> . At least in infants and children, breath-holding attacks are also widely recognized as<unk>  anoxic seizures. Other types include cardiac<unk>  (including long QT disorders, other cardiac arrhythmias, and structural cardiac disease),<unk>  due to standing (see orthostatic hypotension), hyperventilation, compulsive Valsalva maneuvers, gastroesophageal<unk>  disease, and imposed upper airway obstruction(suffocation). In addition, anoxic seizures are a feature of both hyperekplexia and familial rectal pain syndrome. Finally, there are likely to be other types of anoxic seizure or<unk>  not yet characterized.
Reflex asystolic syncope
Reflex syncope
Laughter-induced syncope
Heat syncope
Hair-grooming syncope
Transient loss of consciousness
False awakening
Reflex seizure