Which type of breath-holding spell is characterized by crying followed by forced expiration?

The type of breath-holding spell characterized by crying followed by forced expiration is indeed cyanotic breath-holding. In this scenario, the child typically becomes upset or angry, which triggers intense crying. The crying leads to hyperventilation, and once the child exhales forcefully, it may result in a temporary cessation of breathing. As a consequence of reduced airflow, the child can become cyanotic, indicating that there is insufficient oxygenation.

Cyanotic breath-holding spells are distinct in that they involve the child turning blue due to hypoxia, unlike other types. Pallid spells, on the other hand, are more like fainting episodes that occur after a scream or injury, typically accompanied by pallor rather than cyanosis. Reflex spells are not a recognized classification in this context, and neurogenic refers to spells related to a neurological cause rather than the physiological response seen in breath-holding. Thus, the key features of crying followed by forced expiration leading to cyanosis align specifically with the definition of a cyanotic breath-holding spell.