The little girl who can't play peek-a-boo in case it triggers a fatal fit
Fits cause Abi Marshall's breathing to stop putting her at risk of brain damage



14:42 GMT, 2 May 2012

A toddler can't play the game peek-a-boo because of a rare condition that means an unexpected shock can cause a fatal fit.

Two-year-old Abi Marshall suffers from Reflex Anoxic Seizures, which means extreme emotions can make her heart and breathing stop temporarily.

The youngster was just ten-months-old when she had a first fit and has even suffered five in one day.

Abi Marshall

Ssh! Abi Marshall's parents try to stop their daughter from being surprised as it can trigger a fit

Surprise, pain and excitement can trigger a seizure so her mother Cherish Ayres, 26, tries to make sure her daughter avoids the unexpected.

Ms Ayres, from Crawley, West Sussex, said: 'Playing something like peek-a-boo is out of the question.

'Her cousin can just brush past her or the door will bang and she will have a seizure.

'Something will make her jump and her face will freeze. Her body locks and her eyes roll back in her head. Then she falls to the ground. It’s like she’s frozen in time. Her heart and brain stops.

'Her back arches and she will have a fit. The longer she’s unconscious, the longer she’s starved of oxygen, which can cause brain damage.'

Abi, who is unable to go to nursery because of her condition, was at home with her parents when she had her first fit.

Ms Ayres said: 'We’d just got in from shopping. My keys had been left on the side by the bags and Abi picked them up.

'I took them off her and carried on putting the shopping away. When I turned around again she’d gone all floppy.

'I picked her up then she went completely unconscious. I really thought she had gone. I didn’t think she was coming back.'

Cherish and Dave with daughter: They are hoping Abi will grow out of the condition

Cherish and Dave with daughter: They are hoping Abi will grow out of the condition

Father Dave, 26, who works for McLaren, quickly checked Abi’s airways thinking she had accidentally swallowed something, while Cherish called an ambulance. /05/02/article-2138314-12E18FA0000005DC-523_224x387.jpg” width=”224″ height=”387″ alt=”Cherish said of Abi: 'She's a really girly girl, she just can't stop chatting'” class=”blkBorder” />

Cherish said of Abi: 'She's a really girly girl, she just can't stop chatting'

Cherish said of Abi: 'She's a really girly girl, she just can't stop chatting'

Back at the hospital, Abi had three ECGs to record electrical activity in her heart and an ultrasound scan.

During this time, she caught a viral infection and her heart rate became dangerously high.

Abi was rushed into hospital and was kept in for four days while they monitored her heart.

Doctors were left baffled when all the tests came back clear so Abi was later referred to a specialist at the Royal Brompton Hospital in London.
She was diagnosed with RAS last month.

Ms Ayres said: 'The condition is so hard to diagnose. They had to eliminate everything else first.

'Having a diagnosis felt like a weight had been lifted.'

Reflex Anoxic Seizures are caused by the vagus nerve being over stimulated due to an unexpected stimulus such as pain, shock or fear.

It can cause a sudden lack of blood in the brain, which means she temporarily stops breathing and loses consciousness.

There is no known cure for the condition but children’s attacks tend to lessen as they get older. Her parents hope Abi will eventually grow out of the condition.

Doctors have shown her parents how to put their daughter in the recovery position and have warned them to avoid surprising Abi.

Ms Ayres, who gave up her job as a receptionist to care for Abi said: 'We can’t make her jump. It’s an impossible task. There’s no telling.

'She has to be in my sight all the time.'

However, despite her condition her parents say Abi is just like any other girl her age.

Ms Ayres said: 'She’s a really girly girl. She doesn’t stop chatting.

'We try to keep things as normal as possible. Her condition won’t stop her doing things other kids do.'

Her parents are now waiting for Abi to be fitted with a device to monitor how long her heart stops during an episode to see if she will need a pacemaker when she is older.

Dr Jan Till, a consultant paediatric in electrophysiology at the Royal Brompton and Harefield NHS Foundation trust, said: 'Reflex Anoxic Seizures (RAS) are a type of reflex attack, most common among children aged 18 months to five years, which are triggered by pain, shock or fright.

'Patients will pass out, the heart stops and their breathing stops and this can be very shocking for small children and their families.

'In very extreme cases a pacemaker can be discussed as one option to help manage these episodes.

'Most children grow out of RAS and will suffer no long term effects on their health.'

For more information about Reflex Anoxic Seizures, visit