Despite reductions in sudden unexpected infant death (SUID) and other causes of mortality in childhood, the rate of SUDC has increased during the past two decades (35). |Image courtesy: Pixabay, It could happen to a healthy child as well, and death comes almost immediately. 3. A similar distribution of GCL alterations has consistently been reported in explained control groups of SUDC cohorts (15, 16). Epilepsy Behav. Whatmany parents dont know is that even older children can die suddenly and from no apparent cause. Sudden unexplained death in childhood. Evaluation of forensic autopsy cases. Some experimental data suggest seizure induced neurogenesis and altered neuronal migration as playing a causal role in GCL alterations (4951). Medicolegal Death Investigation System: Workshop Summary. Structural imaging biomarkers of sudden unexpected death in epilepsy. She also worked as the Director of HerStyleAsia.com and handled content strategy and management for APAC markets. In: Duncan JR, Byard RW, editors. Download theAsianparent Community on iOS or Android now! Paterson DS, Trachtenberg FL, Thompson EG, Belliveau RA, Beggs AH, Darnall R, et al. The paucity of SUDC literature precludes a detailed protocol-driven systematic review of the topic: published reports consist predominantly of limited autopsy-based case series or epidemiologic observations from a limited number of registries and cohorts. However, other experimental data suggest GCL alterations as causal in seizure genesis, so the question of cause vs. effect remains unresolved (52, 53). First defined in 2005, SUDC cases are more often male, with death occurring during a sleep period, being found prone, peak winter incidence, associated with febrile seizure history in ~28% of cases and mild pathologic changes insufficient to explain the death (1, 2). Eleven mothers who suffered the heartbreaking loss of a son or daughter to sudden unexplained death in childhood conquer highest mountain in Wales and raise 8,000 for the charity SUDC UK. Copyright 2020 McGuone, Crandall and Devinsky. doi: 10.1016/j.resp.2018.03.004, 67. |Image courtesy: Pixabay, It could happen to a healthy child as well, and death comes almost immediately. Deaths from another fatal childhood condition, sudden infant death syndrome, have plummeted by 80% since the spotlight was turned on it 30 years ago, according to SIDS charity The Lullaby Trust. Molecular testing has yielded high rates of pathogenic cardiac variants in up to 25% of cases of published sudden death cohorts, and ~12% of explained sudden pediatric deaths which possibly explain cause and mechanism of death in some cases, underscoring the necessity of comprehensive ancillary testing to identify causes (15, 20, 21). doi: 10.1097/00000433-200212000-00001, 34. doi: 10.1093/jnen/nlw075, 15. Given these converging strands of evidence, hippocampal abnormalities have emerged as a potential risk factor for seizure-like mechanisms responsible for SUDC, potentially mediated through apneic seizures and cardiorespiratory dysregulation (40). Greater interdisciplinary participation in research efforts is also crucial to elucidate underlying mechanisms, identify children are at increased for sudden death, and to institute appropriate screening and preventative strategies. Kinney HC, Chadwick AE, Crandall LA, Grafe M, Armstrong DL, Kupsky WJ, et al. An audit of the quality of autopsy reporting. 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Finally, even in adults with epilepsy, sudden death can occur during video electroencephalogram (EEG) monitoring without clinical or electrographic evidence of a seizure, and autopsies reveal no alternative causes. Dentate gyrus abnormalities in sudden unexplained death in infants: morphological marker of underlying brain vulnerability. This work was supported by the SUDC Foundation and Finding a Cure for Epilepsy and Seizures (FACES). Shocked Sharon Anderson was at work in a hospital operating department when her 14-month-old, Tobias, was rushed in and died. (2009) 117:24755. doi: 10.1016/S1474-4422(13)70214-X, 69. What Causes Sudden Infant Death Syndrome (SIDS)? Further, the low incidence of SUDC creates additional challenges for healthcare providers who often rely on an interdisciplinary approach to recently bereaved families, and interface with the medico-legal system (8, 11). On the basis of the probable causes of sudden unexplained death of a child, NORD suggests that one must keep an eye out for signs of seizures. (2015) 56:1294300. These are only suspected causes. Future detailed studies are necessary to elucidate the mechanism of hippocampal alterations, and explore connections with brainstem dysfunction. NORD explains, Each year, more than 1 out of 1,000 people with epilepsy die from SUDEP. But if there is a family history of any of these conditions, its best to get your child checked with a specialist at least once, for peace of mind. Kinney HC. As per the National Organisation for Rare Disorders (NORD), here are some shocking statistics: So what is this mysterious and silent child killer?. NORD stated on their website, Most were born as full-term singletons and their development was considered normal. Moreover, exome sequencing of SUDEP cases has identified an excess of variants in genes that regulate ion channels in cardiac and brain tissue (22, 23). The Past, the Present and the Future. SIDS Sudden Infant and Early Childhood Death. Sudden Unexpected Death in Infancy and Childhood. 29. doi: 10.20851/sids-29, 41. doi: 10.1093/jnen/nlz136, 16. Copyright theAsianparent 2022. In some cases, a distinction between SUDC and SUDEP may be semantic as some SUDC cases had epilepsy syndromes retrospectively diagnosed based on genetic and other data, but epilepsy was not recognized before death. Snowdon was made more special because the other mums were there.. Data Are From the Multiple Cause of Death Files, 1999-2017, as Compiled From Data Provided by the 57 Vital Statistics Jurisdictions Through the Vital Statistics Cooperative Program, Atlanta, GA (2018). One proposed mechanism of SUDC associated with FS includes thermal sensitivity of the developing brain central homeostatic network (40). Crandall L, Devinsky O. Retrospective, small SUDC studies with non-standardized methodologies most often demonstrate minor hippocampal abnormalities, as well as focal cortical dysplasia and dysgenesis of the brainstem and cerebellum. Forensic Sci Med Pathol. Crandall LG, Lee JH, Stainman R, Friedman D, Devinsky O. Candice was a healthy child. doi: 10.1016/j.yebeh.2018.11.006, 63. Got a parenting concern? Pediatr Pathol. Insights from structural and resting-state functional MRI studies. Neuropathologic findings in SUDC are particularly relevant when a seizure is postulated as the immediate mechanism of death. (2000) 97:86570. Two deaths were associated with apnea and convulsions. Nearly 90 percent of those affected by SUDC are born full-term and healthy. Sarnyai Z, Sibille EL, Pavlides C, Fenster RJ, McEwen BS, Toth M. Impaired hippocampal-dependent learning and functional abnormalities in the hippocampus in mice lacking serotonin(1A) receptors. Mums . Unexpected death of a child with complex febrile seizures-pathophysiology similar to sudden unexpected death in epilepsy? 37. Further, young children can have non-convulsive seizures that cause respiratory arrest and near-death events (36, 37). J Neurosci. Reelin deficiency and displacement of mature neurons, but not neurogenesis, underlie the formation of granule cell dispersion in the epileptic hippocampus. Pediatr Dev Pathol. (1983) 72:1817. They have all lost a son or daughter to sudden unexplained death in childhood but say too little is known about the condition. 74. Eating disorder and epilepsy in mice lacking 5-HT2c serotonin receptors. doi: 10.1212/WNL.0000000000007969, 49. Sudden Unexplained Death in Childhood (SUDC) is the unexpected death of a child over age 12 months that remains unexplained after a thorough case investigation, including review of the child's medical history, circumstances of death, a complete autopsy and ancillary testing (1). Make a difference now and help families grieving the sudden and unexplained death of a child. M Institute of S. Committee for the Workshop on the Medicolegal Death Investigation. Children were in their state of usual good health prior to death, or had mild symptoms of illness such as cold symptoms or fever. Children who died placed supine (chest facing upwards towards the ceiling): 10 percent, Those who died lying on the side: 2 percent, Kids found with their faces positioned downwards: 10 percent, Those found with their faces positioned on the side: 8 percent, Those co-sleeping with parents/guardians: 3 percent, Incidents of children who were found with their bodies, Obstruction of airway, especially if the child is lying face down on the bed, Filling of fluid in the lungs post a seizure, Those with abnormal electrical heart rhythms. Neurology. However, Dr Krous says there is hope because parents can take preventive measures. Br KJ, Herbsleb M, Schumann A, de la Cruz F, Gabriel HW, Wagner G. Hippocampal-brainstem connectivity associated with vagal modulation after an intense exercise intervention in healthy men. Mosaic mutations in early-onset genetic diseases. (2014) 24:213040. Reportedly, SUDC affectsabout 1.4 deaths per 100,000 children globally. (1995) 374:5426. Ajayi IE, McGovern AE, Driessen AK, Kerr NF, Mills PC, Mazzone BS. Exome-based analysis of cardiac arrhythmia, respiratory control, and epilepsy genes in sudden unexpected death in epilepsy. Abnormalities in medullary serotonergic neurons and receptors, as well as cardiorespiratory brainstem nuclei occur in some SUID cases, but have never been studied in SUDC. Heinrich C, Nitta N, Flubacher A, Muller M, Fahrner A, Kirsch M, et al. It doesnt affect one particular ethnic group more than others.. However, the frequent association of GCL alterations and FS history in SUDC has prompted some researchers to suggest that GCL is a marker of seizure vulnerability in early life, potentially through age-dependent mechanisms involving altered limbic-brainstem connections (38). It is the lesser-known cousin of Sudden Infant Death Syndrome (SIDS), which the Centers for Disease Control and Prevention (CDC) defines as "the sudden death of an infant less than one year of age that cannot be explained after a thorough investigation is conducted, including a complete autopsy, examination of the death scene, and review of the clinical history." Hippocampal anomalies of the DG, analogous to SUDC, occur in some SUDEP brains, but are not common in SUDEP and many epilepsy patients who die from other causes have hippocampal abnormalities (32). Doctors think he may have had another seizure. Table 2. This means that we may include adverts from us and third parties based on our knowledge of you. Teacher Kimberley Shepherd lost her only child, 11-year-old Liam, in March 2021. Inheritance of febrile seizures in sudden unexplained death in toddlers. Sudden Unexplained Death in Childhood (SUDC) is the unexpected death of a child over age 12 months that remains unexplained after a thorough case investigation, including review of the child's medical history, circumstances of death, a complete autopsy and ancillary testing (1). Folkerth RD, Nunez J, Georgievskaya Z, McGuone D. Neuropathologic examination in sudden unexpected deaths in infancy and childhood. Collins KA, Byard WR. The rate of SUDC is increasing, even as mortality from sudden unexpected infant death (SUID) continues to fall (35). (2014) 55:e612. (2016) 12:1989. Read This Before You Enjoy the Satisfaction of Cracking Your Joints! Tester DJ, Medeiros-Domingo A, Will ML, Haglund CM, Ackerman JM. (2016) 79:52234. So you should watch out for these as well. Sign up for our newsletter. It is the 5th leading category of death in children aged 14 years, and resulted in 243 deaths in 2017 (7). Finally, although essential for public health surveillance, the medical death investigation system is under-resourced, short-staffed, and chronically under-funded, problems which have deepened during the opioid epidemic, and COVID-19 novel coronavirus disease pandemic. Learn MoreOk, Got it, This silent killer usually affects children. | Image courtesy: Pixabay, In addition to this information, the NORD found that almost all children with SUDC were supposedly sleeping before they became unresponsive., You might wonder, if it is unexplained then how can there be a cause? Other studies have identified similar trends, and countries that routinely track SUDC mortality report a gradual increase in incidence over time (4, 8385). Sudden Unexplained Death in Childhood (SUDC) is the unexpected death of a child over age 12 months that remains unexplained after a thorough case investigation, including review of the child's medical history, circumstances of death, a complete autopsy and ancillary testing (1). Brain. doi: 10.1046/j.0305-1846.2001.00325.x, 48. The mum of two other children, from Barrow-in-Furness, Cumbria, said: Kiana had no signs of a cold, fever or seizure and went to bed that night fine and happy. doi: 10.1016/j.forsciint.2012.08.024. doi: 10.1007/s12024-016-9768-y, 66. I knew in my heart he was gone. It remains unclear whether hippocampal structural changes in SUDC can result from disturbed neurotransmission due to an intrinsic brainstem serotonergic defect arising during early development. Norman MG, Taylor GP, Clarke AL. doi: 10.1111/bpa.12596, 45. Proc Natl Acad Sci USA. (2018) 28:64455. In addition to this information, the NORD found that almost all children with SUDC were supposedly sleeping before they became unresponsive. Sudden death in toddlers associated with developmental abnormalities of the hippocampus: a report of five cases. October 6, 2022 | Sudden Unexplained and Unexpected Deaths with Amanda Brindle, LSW from the SUDC Foundation. Paramedic Becca Luisi found daughter Kiana dead in bed in November, 2005 two days before the tots second birthday. Hippocampal morphometry in sudden and unexpected death in epilepsy. Brainstem serotonergic and autonomic nuclei are critical in controlling arousal as well as cardiorespiratory centers that respond to life-threatening hypoxia or hypercarbia during sleep. (1988) 533:1330. NORD lists a few possible reasons for sudden unexplained death in a child. Nat Neurosci. Since SADS is caused by genetics, it is usually passed down from a parent to a child. Then why did she die?. Am J Forensic Med Pathol. Hippocampal malformation associated with sudden death in early childhood: a neuropathologic study. Keeling JW, Knowles AS. Notably, the same group that has championed the role of hippocampal abnormalities in SUDC and SUID had previously highlighted the role of medullary serotonin and other brainstem abnormalities, including structural abnormalities in the inferior olive, reactive gliosis in the medulla, interleukin 6 and nicotinic and muscarinic receptor abnormalities in the medulla (5759).