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Apparent life-threatening event: a neurologic perspective
1Jacobo Lichtmann Apnea Investigation Unit, Department of Pediatrics, Bnai Zion Medical Center, Haifa, Israel.
Insights
Central nervous system disorders are often undiagnosed in infants experiencing apparent life-threatening events. Routine electroencephalography can identify these neurological conditions, even without obvious clinical signs.
Area of Science:
- Neurology
- Pediatrics
Background:
- Apparent life-threatening events (ALTEs) in infants require thorough investigation.
- Central nervous system (CNS) disorders can manifest as ALTEs.
Observation:
- In a study of 46 infants with ALTEs, 15% were diagnosed with CNS disorders.
- Diagnoses included convulsive disorders, intraventricular hemorrhage, hydrocephalus, absent corpus callosum, and developmental deficits.
- Four of these seven infants had no suspected neurological deficit prior to the event.
Findings:
- Electroencephalographic (EEG) studies would have identified the underlying disorder in all four infants with initially unsuspected neurological deficits.
- EEG is a valuable tool for diagnosing CNS disorders in infants presenting with ALTEs.
Implications:
- Central nervous system disorders should be routinely screened for in infants with ALTEs, irrespective of clinical presentation.
- Early identification of neurological conditions through EEG can lead to timely intervention and improved outcomes for infants with ALTEs.
Abstract:
Of 46 infants who were investigated for apparent life-threatening events, central nervous system disorders were diagnosed in seven (15%). Convulsive disorders, intraventricular hemorrhage and hydrocephalus, absent corpus callosum, and development deficits were found. In four of the seven, no neurologic deficit was suspected before the event. Electroencephalographic studies (overnight in two) would have identified the disorder in all four. Electroencephalography is therefore a recommended routine procedure in investigation of apparent life-threatening events. Central nervous system disorders should be routinely ruled out in cases of apparent life-threatening event, even in the absence of clinical clues.