Apparent life-threatening events: neurological correlates and the mandatory work-up.
The purpose of this study was to estimate the prevalence of neurological causes for apparent life-threatening events in infants and assess the neurological work-up mandatory to diagnose such diagnosis, hypothesizing that acute neurological disorders constitute the most common etiology for such an acute event. A retrospective chart review allocated 93 infants fulfilling the criteria of the National Institutes of Health presenting at 1 week to 8 months with apnea, color changes, gagging, unresponsiveness, and alterations of body tone. An underlying neurological etiology was detected in 18 (19%), whereby 15 had seizures and 3 had central apnea. Only one electroencephalography demonstrated epileptic discharges, and brain imaging was intact. Thus, it has been concluded that neurological impairment, mainly that of seizures inducing an apparent life-threatening event, are relatively uncommon. As such, recommendations are that history taking and repeat physical examination still remain the major diagnostic tools before resorting to extensive laboratory studies.
Genizi
Jacob
J
Child Neurology Unit & Epilepsy Service, Meyer Childrens Hospital, Rambam Medical Center, Rappaport School of Medicine, Haifa 31096, Israel.
Pillar
Giora
G
Ravid
Sarit
S
Shahar
Eli
E
D001049:Apnea / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D010808:Physical Examination / Q000379:methods / Q000592:standards*; D012189:Retrospective Studies; D013398:Sudden Infant Death / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control