Article ; Online: Video Analyses of Sudden Unexplained Deaths in Toddlers.
2024 Volume 102, Issue 3, Page(s) e208038
Abstract: Background and objectives: More than 2,900 US children aged younger than 4 years die from unknown causes each year, accounting for more than 219,000 life years lost annually. They are mostly sleep-related and unwitnessed with unremarkable autopsies, ... ...
| Abstract | Background and objectives: More than 2,900 US children aged younger than 4 years die from unknown causes each year, accounting for more than 219,000 life years lost annually. They are mostly sleep-related and unwitnessed with unremarkable autopsies, limiting our understanding of death mechanisms. We sought to understand potential mechanisms of death by evaluating videos of sudden deaths in toddlers. Methods: In our registry of 301 sudden unexplained child deaths, a series of 7 consecutively enrolled cases with home video recordings of the child's last sleep period were independently assessed by 8 physicians for video quality, movement, and sound. Results: Four boys and 3 girls (13-27 months at death) with terminal videos shared similar demographic features to the 293 other registry cases without video recordings. Five video recordings were continuous and 2 were triggered by sound or motion. Two lacked audio. All continuous recordings included a terminal convulsive event lasting 8-50 seconds; 4 children survived for >2.5 minutes postconvulsion. Among discontinuous videos, time lapses limited review; 1 suggested a convulsive event. Six were prone with face down, and 1 had autopsy evidence of airway obstruction. Primary cardiac arrhythmias were not supported; all 7 children had normal cardiac pathology and whole-exome sequencing identified no known cardiac disease variants. Discussion: Audio-visual recordings in 7 toddlers with unexplained sudden deaths strongly implicate that deaths were related to convulsive seizures, suggesting that many unexplained sleep-related deaths may result from seizures. |
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| MeSH term(s) | Male ; Female ; Humans ; Child, Preschool ; Infant ; Death, Sudden/epidemiology ; Death, Sudden/etiology ; Heart Diseases/complications ; Arrhythmias, Cardiac/complications ; Seizures, Febrile ; Seizures/complications ; Cause of Death ; Death, Sudden, Cardiac/etiology | |||||||||||||||
| Language | English | |||||||||||||||
| Publishing date | 2024-01-04 | |||||||||||||||
| Publishing country | United States | |||||||||||||||
| Document type | Journal Article | |||||||||||||||
| ZDB-ID | 207147-2 | |||||||||||||||
| ISSN | 1526-632X ; 0028-3878 | |||||||||||||||
| ISSN (online) | 1526-632X | |||||||||||||||
| ISSN | 0028-3878 | |||||||||||||||
| DOI | 10.1212/WNL.0000000000208038 | |||||||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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