Cardiac pacing in the management of severe pallid breath-holding attacks.

Reflex anoxic seizures (pallid breath-holding attacks) can be managed with reassurance in the majority of individuals. In a minority of cases where frequent syncopal and seizure activity occurs, intervention needs to be considered. We report a case of a 19-month infant with a history of severe reflex anoxic seizures who underwent pacemaker insertion with a spectacular result, with complete termination of syncope and seizures, and improvement in quality of life for the patient and family. A literature review of the safety and effectiveness of pacemaker insertion is also presented to support its use as a treatment option for this condition.