Video Analyses of Sudden Unexplained Deaths in Toddlers
Abstract number :
1.473
Submission category :
2. Translational Research / 2A. Human Studies
Year :
2023
Submission ID :
1275
Source :
www.aesnet.org
Presentation date :
12/2/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Laura Gould, MSc, MA, PT – NYU Grossman School of Medicine
Presenting Author: Orrin Devinsky, MD – NYU Langone Medical Center
Codi-Ann Reid, BS – NYU Grossman School of Medicine; Alcibiades Rodriguez, MD – NYU Grossman School of Medicine; Orrin Devinsky, MD – Neurology – NYU Grossman School of Medicine
Rationale: More than 2900 U.S. children under four years of age die from unknown causes each year, accounting for more than 219 thousand life years lost annually. They are mostly sleep-related and unwitnessed with unremarkable autopsies, limiting our understanding of death mechanisms. We sought to understand potential mechanisms of death by evaluating videos of sudden deaths in toddlers.
Methods: In our registry of 301 sudden unexplained child deaths, a series of seven consecutively enrolled cases with home video recordings of the child’s last sleep period were independently assessed by eight physicians for video quality, movement, and sound.
Results: Four males and three females (13-27 months at death) with terminal videos shared similar demographic features to the 293 other registry cases without video recordings. Five video recordings were continuous and two were triggered by sound or motion. Two lacked audio. All continuous recordings included a terminal convulsive event lasting eight to fifty seconds; four children survived for > 2.5 minutes post-convulsion. Among discontinuous videos, time lapses limited review; one suggested a convulsive event. Six were prone with face-down and one had autopsy evidence of airway obstruction. Primary cardiac arrhythmias were not supported; all seven children had normal cardiac pathology and whole exome sequencing identified no known cardiac disease variants.
Conclusions: Audio-visual recordings in seven toddlers with unexplained sudden deaths strongly implicate deaths were related to convulsive seizures, suggesting that many unexplained sleep-related deaths may result from seizures.
Funding: SUDC Foundation, FACES and National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, UL1TR001445
Translational Research