• Posted January 5, 2024

Seizures Could Play Role in Sudden Unexplained Deaths Among Toddlers

Most people have heard of sudden infant death syndrome (SIDS), where babies die during sleep for reasons that aren't always clear.

But every year, about 400 cases of similar "sudden unexplained deaths in children" (SUDC) occur in the United States among a slightly older age group -- toddlers.

New research, involving video from baby monitors and security cameras, may reveal a cause for these tragedies.

“Our study, although small, offers the first direct evidence that seizures may be responsible for some sudden deaths in children, which are usually unwitnessed during sleep,” lead investigator Laura Gould, a research assistant professor at NYU Langone, said in a university news release.

The research is personal for Gould: In 1997, she lost her daughter Maria, aged 15 months, to SUDC. That loss spurred her to launch the NYU SUDC Registry and Research Collaborative a decade ago.

The new findings were published Jan. 4 in the journal Neurology.

In the study, Gould and her colleagues turned to medical records, plus video from family baby monitors or home security systems placed in toddlers' bedrooms, to try and determine factors that led to cases of SUDC.

All of this data, involving more than 300 cases, came from the registry Gould helped set up.

The team found that at least one in every three cases of SUDC were potentially caused by seizures.

That's in line with prior research, which had already found that children who died suddenly and unexpectedly were 10 times more likely to have a history of fever-associated (febrile) seizures, compared to children who did not die suddenly.

A panel of eight physicians reviewed those rare cases of SUDC in which video was available of the child around the time of death.

In five of the seven videos reviewed, sound and visuals revealed signs of a seizure happening. In a sixth video, signs of muscle convulsion were also seen.

Seizures typically lasted only a minute, and usually occurred about 30 minutes prior to death.

The researchers noted that only one of the toddlers in the videos had a prior history of febrile seizures. On autopsy, no definitive cause of death had been determined for any of the children.

According to lead investigator Dr. Owen Devinsky, "these study findings show that seizures are much more common than patients' medical histories suggest, and that further research is needed to determine if seizures are frequent occurrences in sleep-related deaths in toddlers, and potentially in infants, older children and adults."

Devinsky is a professor of neurology, neurosurgery, and psychiatry at NYU Langone and chief of its epilepsy service.

He added that it's still not clear how a brief seizure might lead to a child's death, and more research is needed. Based on prior research in people with epilepsy, it's known that seizures can lead to subsequent interruptions in breathing, and death can result -- especially if the person is lying face down while sleeping.

Devinsky said seizure-related deaths are underreported in people generally, whether or not they have epilepsy.

More information

Find out more about SUDC at the Sudden Unexplained Death in Childhood Foundation.

SOURCE: NYU Langone, news release, Jan. 4, 2024