Cyanotic breath-holding spells were suspected by the clinical description. This common entity occurs in 5% of healthy children usually beginning in the first year of life1. Cyanotic breath-holding spells may be confused with seizures. In this case, the typical presentation was complicated by an "abnormal" EEG. The minimal movement produced by maternal tickling induced artifact that mimicked a focal seizure. EEG interpretation may be subject to misidentification of artifact, normal variants, or variations of normal patterns when electrophysiological properties are neglected due to bias or limited experience leading to diagnostic errors that translate to inappropriate treatment2. A general medical and cardiology evaluation were normal and her spells tapered and finally stopped after 3 years.
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