It usually occurs when the child is angry or frustrated and may be a component of a temper tantrum.
Cyanotic BHS may be a component of a temper tantrum or a child's attempt to gain control over a situation.
A child over the age of two with daily spells may have learned that intense crying or a temper tantrum can trigger a spell.
Permissive parents often feel as if they "have to" give in to avoid crying or a temper tantrum.
Their behaviors may seem similar, and when they do have difficulties, they may manifest in ways that appear simply unruly or disruptive - nothing more than a temper tantrum.