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Apparent Life-Threatening Events: Neurological Correlates and the Mandatory Work Up

¹ From Child Neurology Unit & Epilepsy Service, Meyer Children’s Hospital, Rambam Medical Center, Rappaport School of Medicine, Haifa, Israell
² From the Sleep Laboratory, Meyer Children’s Hospital, Rambam Medical Center, Rappaport School of Medicine, Haifa, Israell

^* To whom correspondence should be addressed. E-mail: e_shahar{at}rambam.health.gov.il.

	Abstract

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.

First published on July 21, 2008, doi:10.1177/0883073808318204

Journal of Child Neurology 2008;23:1305.

A more recent version of this article appeared on November 1, 2008


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