Recordings imply that convulsions might immediately come before particular cases of unexpected demise in youngsters. (Image credit: Ann in the UK/Shutterstock)ShareShare by:
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According to a recent study that examined video records of these children’s final instances, certain unexplained fatalities in young children may be associated with seizures.
The investigation represents an effort to gain insight into sudden unexpected death in children, or SUDC, which occurs when a seemingly robust young child passes away abruptly, and neither an autopsy nor a death probe uncovers any clear etiology. SUDC bears some resemblance to sudden infant death syndrome (SIDS), frequently taking place while the child is sleeping and in youngsters who appear to be growing normally. Nevertheless, SUDC impacts kids aged 1 to 18, distinct from SIDS, which transpires before a child attains their first birthday.
SUDC is less frequent than SIDS; among unexplained deaths in children aged 4 or younger, SIDS constitutes 90% of instances, whereas SUDC constitutes 10%. According to a 2020 study, the SUDC rate among 1- to 4-year-olds is 1.5 per 100,000 children, making it the fifth-highest cause of mortality in this demographic. Laura Gould, a researcher at NYU Langone Medical Center and the lead author of the new study, stated that these losses are deeply disturbing for families.
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“The bereavement of a child is shattering, and the lack of understanding regarding the reason behind the tragedy introduces an added dimension of distress and complexity,” Gould conveyed to Live Science. The recent study furnishes explicit proof of children undergoing convulsions and muscular spasms immediately preceding their demise. Nonetheless, given that it encompassed only a limited cohort of children, further investigation is requisite to ascertain the precise prevalence of convulsions among SUDC sufferers.
SUDC was formally characterized by physicians merely in 2005, implying that inquiry into this occurrence remains comparatively nascent, according to Gould. The CDC currently monitors SUDC instances; however, there exists a dearth of data preceding 2005.
Gould, who collaborated on the official characterization of SUDC in the aftermath of her own daughter’s passing in 1997, co-established the SUDC Registry and Research Collaborative (SUDCRRC), which is dedicated to comprehending SUDC’s origins and has documented over 350 cases to date.
“We exercise thoroughness in amassing comprehensive information pertaining to the child, encompassing their medical background, family lineage, as well as DNA and other biological samples,” Gould elucidated.
In recent times, a select group of families registered with the registry disclosed the presence of nursery surveillance devices capable of capturing and storing video footage of the events. Because SUDC typically occurs without witnesses, such recordings present an extraordinary opportunity to discern the circumstances surrounding the children’s terminal sleeping period, despite their undeniable emotional burden, as Gould indicated.
In the current investigation, the researchers scrutinized the initial seven videos gathered by the SUDCRRC. Eight medical professionals assessed each recording, comprising six forensic medical experts and two specialists in epilepsy. Gould pointed out that all reviewers were extended mental health support to address the distressing nature of the videos.
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Two of the recordings were activated by sound or movement, implying that they captured brief snippets of the child’s rest. The other five were continuous. Each of the continuous recordings depicted the children undergoing convulsions before succumbing, and one movement-activated recording was suggestive of a seizure as well.
The solitary prior link connecting SUDC and seizures stemmed from the recognition that children reporting a history of febrile seizures, indicative of those resulting from fever, are at a heightened vulnerability to SUDC. However, a substantial majority of children afflicted by febrile convulsions overcome them without incurring adverse repercussions. The current endeavor highlights the imperative for a more profound scrutiny of this association, Gould stated.
She noted that, among the children featured in the recordings, one had experienced prior febrile seizures, while the remaining six had not.
The etiology of the seizures cannot be ascertained based on the recordings. Nevertheless, Gould noted that the seizures may have served as the catalyst precipitating the deaths. The recordings furnished no indication of any preceding events or cardiovascular abnormalities, nor did the children exhibit genetic predispositions to cardiac complications. Although epilepsy is uncommonly linked to unexpected death across various age groups for reasons that remain incompletely elucidated, none of the children involved in the study possessed a history of epilepsy.
Four recordings continued subsequent to the seizures, intimating that the children lingered between 2.5 and 26 minutes before ceasing respiration.
“There are two primary inquiries that still elude our comprehension: What prompted these seizures in the children, and why did these seizures lead to their deaths?” Gould inquired. “All of these seizures were less than a minute in duration, occurring during slumber. While we still classify them as unexplained deaths, we now recognize that the mechanism of mortality implicates seizures.”
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Gould disclosed that in other studies, the investigators have sequenced the protein-encoding genes of some children who passed away due to SUDC, but whole-genome sequencing could unveil further insights into the processes at play in these instances. The results might also counsel that medical practitioners deliberate on the SUDC risk with families of children who experience febrile convulsions, or explore the benefits of employing wearable monitoring devices at home for these children, she stated.
For children without a history of febrile convulsions, the prospective guidance lacks clarity.
“The consensus generally holds that safe sleep recommendations are unequivocally defined for infants,” Gould commented. “Toddlers face the greatest susceptibility to febrile seizures, yet the recommendations for their sleep habits are considerably less precise, so I would hope that this encourages renewed discussion on the topic.”
The researchers’ latest discoveries were disseminated on January 4 in the publication Neurology.
This article is intended for informational purposes solely and does not constitute medical consultation.
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Stephanie PappasSocial Links NavigationLive Science Contributor
Stephanie Pappas is a writer contributing to Live Science, encompassing a spectrum of domains spanning geoscience, archaeology, the human brain, and conduct. Formerly a senior writer at Live Science, she currently functions as a freelancer situated in Denver, Colorado, and regularly provides content to Scientific American and The Monitor, the periodical of the American Psychological Association. Stephanie attained a bachelor’s degree in psychology from the University of South Carolina and a graduate certificate in science communication from the University of California, Santa Cruz.
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