Our objective was to determine the efficacy of Piracetam on the treatment of breath holding spells. Inclusion criteria: 1- History of breath- Holding spell 2- minimum age 6 month and maximum 3 years old 3- Normal EEG3 4- absent of systematic disease 5- Normal growth and Development 6- No history of epilepsy in family members 7- No Electrolyte Abnormalities (Hypoglycemia & Hypocalcaemia). Exclusion criteria: 1) Children with history of convulsion 2) Children that received Anticonvulsant drugs. 3) Delayed neurotic development 4) all Children with heart diseases 5) all children with anemia. Hundred patients with Breath Holding spell were randomized in two groups. First group received placebo and the other received 40 mg/kg/day priacetam. Then we evaluated the number of breath holding spell before intervention, 2 weeks and 2 month after intervention.