Death, Child Abuse, and Adverse Neurological Outcome of Infants after an Apparent Life-Threatening Event
Joshus L. Bonkosky,MD, PhDa, Elisabeth Guenther, MD, MPHb,Francis M. Filloux, MDa, Rajendu Srivastava, DD, FRCP, MPHc
Excerpt from article:
Our objectives were to characterize short- and long-term risks for death, child abuse, and abnormal neurological outcomes of infants after an apparent life-threatening event and to identify clinical features that are predictive of these outcomes.
METHODS. We collected data from infants ages birth to 12 months of age who were hospitalized after an apparent life-threatening event during a 5-year time period. Patients were evaluated for subsequent death, child abuse, or adverse neurological outcome (chronic epilepsy or developmental delay.)
RESULTS. A total of 471 patients met inclusion criteria and were followed an average of 5.1 years. Two patients died after developing chronic epilepsy and severe developmental delay. Fifty-four (11%) patients were diagnosed as being a victim of child abuse, but only 2 were identified at initial presentation. There were 23 (4.9) % patients with adverse neurological outcomes, including 17 (3.6) % with chronic epilepsy and 14 (3.0%) with developmental delay. Of those who developed chronic epilepsy, 71% returned within 1 month of the initial apparent life-threatening event with a second event.
So, what is a life threatening event for a child? Is it nearly being run over by a truck? Almost drowning in a swimming pool? Falling out of tree onto pavement? Yes. These are life threatening events for a child. Life threatening for any grown person.
Consider the infant or very young child. What else could be life threatening to them?
1.) A child alone in the house with a mother who won't wake up because she's drugged up on pills and alcholol.
When a child seems something inert they assume it is dead. So, from the child's perspective the mother is dead.
What is the child to? Some may go into denial and create a better imaginary world for themselves. Some may run out of the house and scream (the healthier child) and some children may get a surge of electrical energy, the mind storm, and go into a seizure where they can develope chronic Epilepsy. The apparent loss of a parent with no one around to appeal to...
is a life threating situation for a child.
2.) A child is sexually abused by the father, let's say. The child counts on a benign father to be nurturing and often times this is the case. He will push her on the swing during the day and in the evening push her right into the darkness of sexual abuse. The child gets double messages. She's trapped. How does she survive with no one around to appeal to...
is a life threatening situation for a child
Because I was this child, I was caused Temporal Lobe Epilepsy.
There are so many other scenerios. But know this as fact. Temporal Lobe Epilepsy has to do with the stunting of the left hippocampal volume due to early on trauma.
ABUSE. The one cause, inadvertantly, left off the list in the beginning of this thread, "Possible Causes for Epilepsy and Seizures." Let's not forget it's impact.
http://pediatrics.aappublications.o...INDEX=0&sortspec=relevance&resourcetype=HWCIT