title: Hippocampal asymmetry and sudden unexpected death in infancy: a case report.
abstract: The differential diagnosis of known entities associated with sudden unexpected death in infancy is ever expanding. Here we report the case of a 10-month-old infant boy whose clinical presentation mimicked that of the sudden infant death syndrome (SIDS). This presentation included the typical features of SIDS: sleep-related death; prone position upon discovery; and minor illness within 2 days of death. Nevertheless, neuropathologic examination revealed striking hippocampal asymmetry and microdysgenesis similar to that reported previously by us in toddlers with sleep-related sudden death. Hippocampal maldevelopment in the setting of sudden death in infants and toddlers is analogous to sudden unexpected death in epilepsy associated with temporal lobe pathology, and suggests a possible role for seizures in the terminal events leading to sudden death. This report serves to alert pediatric and forensic pathologists to hippocampal asymmetry and microdysgenesis in the differential diagnosis of sudden infant death mimicking SIDS.
authors.affiliation: Department of Forensic Medicine, Sydney Local Health District, Glebe, NSW, Australia.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rodriguez
authors.forename: Kristin
authors.initials: K
authors.lastname: McMillan
authors.forename: Laura A
authors.initials: LA
authors.lastname: Crandall
authors.forename: Megan E
authors.initials: ME
authors.lastname: Minter
authors.forename: Marjorie R
authors.initials: MR
authors.lastname: Grafe
authors.forename: Annapurna
authors.initials: A
authors.lastname: Poduri
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Kinney
mesh_terms: D001921:Brain / Q000473:pathology; D001929:Brain Edema / Q000473:pathology; D049429:Forensic Pathology; D006624:Hippocampus / Q000002:abnormalities* / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D009929:Organ Size; D013398:Sudden Infant Death / Q000473:pathology*; D013702:Temporal Lobe / Q000002:abnormalities* / Q000473:pathology*; D014711:Vertebral Artery / Q000002:abnormalities / Q000473:pathology