Patients with typical spells should be investigated according to our guidelines

Patients with non-typical spells will be investigated individually, as it is done today

Participant with typical spells will be investigated according to our guidelines. These include that participants with heredity for or signs and symptoms of cardiac disease will be subjected to an ECG and participants with two or more spells should be subjected to blood tests for anemia and iron deficiency

The number of wrongful and missed diagnoses (definition: managed and diagnosed as breath-holding spells at physician assessment within study but later found to be another cause for the symptoms, like long QT syndrome or epilepsy).

Assessed according to the following:

• Number of patients with a diagnostic interventions for each intervention in the guidelines: ECGs and bloodtests.
• Number of found pathologies for each intervention (blood tests and ECGs) - for patients with typical spells handled according to the guidelines and those with non-typical spells managed individually. This includes a retrospective assessment of ECG (a complete assessment including rythm, long QT syndrome, AV-block, ST-segment changes) and blood test results (for anemia and iron deficiency; i.e. values outside of the age adapted normal range).
• Retrospective analysis of the clinical doctors compliance with managment guidelines, evaluated through the number of interventions for each patient that were not recommended in the guidlines (for instance number of EEGs).

Assessed according to the following:

• Adherence to the the prespecified definition of typical spells through comparison of clinical physicians assessment and a retrospective assessment by study physician, i.e. the number of cases with a discrepant judgment of the clinical presentation.
• The number of typical spells compared to the number of non-typical spells and other diagnsoses.
• Compilation of patient and spell characteristics (defined in the variable list in the attached documents) and comparison with the current definition of typical spells.

Through interview study (qualitative study) gather information on given information and support and their need for more information and support. Will be conducted on parents of children with more than 5 spells in total at the 6 month follow up (assessed as frequent spells).

Assessed according to the following parameters, through digital surveys:

• Spells during the last 3 months (yes or no)
• Number of spells the previous month (0, 1, 2-5, 6-10, >10)
• Total number of spells (free text)
• Uncontactable or unconscious (=severity of spells) (Yes, No, Don't know)
• Alterations in spell semiology? (Yes, No, Don't know)