Could Seizures Be Behind Children’s Sudden Unexplained Deaths During Sleep?

In 2021, more than 200 children between ages 1 and 4 died from SUDC. The majority had no obvious heart problems, nervous system problems, or other health issues to explain their death. But children involved in SUDC cases do share one thing in common: they are 10 times more likely to have a history of febrile seizures. 

Febrile seizures are relatively common. About 1 in 25 children experience at least one febrile seizure, often triggered by fever from an illness such as the flu or an ear infection. Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source  

Some experts already suspected a link between seizure history and SUDC, but it has been challenging to prove. For the study, the NYU researchers analyzed video footage of seven SUDC events in sleeping toddlers aged 13 to 27 months. Each of these children knew how to walk and had reached other normal milestones for their age. At the time of death, all of the toddlers were lying face down or had their faces obstructed by bedding. 

After careful analysis, researchers identified short seizures lasting less than a minute in all five videos with continuous footage. The remaining two children had motion-activated video footage. One child appeared to have had a seizure, and the other video was difficult to interpret. 

At least four of the children showed signs of life for several minutes after the seizure. The study authors noted that the seizures appeared to affect the children’s breathing. The seizures likely also dampened their reflexes, explaining why they remained face down instead of shifting positions to breathe better.

Seizures are notoriously hard to detect in an autopsy. Trusted Source Science Direct The leading platform of peer-reviewed literature that helps you move your research forward. View Source “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,” said Laura Gould, MSc, lead author and research assistant professor at NYU Langone.

This study was limited by imperfect video quality and few cases. However, the authors suspect that hidden seizures may be behind most SUDC cases. While just one of the toddlers in this study had a known history of febrile seizures, three of the children had changes to the brain similar to people with epilepsy.

Nighttime seizures may also be responsible for some toddler deaths attributed to other causes, such as infection or asphyxiation, and possibly even unexplained nighttime deaths in young adults. 

So far, there’s not enough evidence to say for sure that seizures cause SUDC events. However, this study is an important step forward in understanding and preventing these rare yet tragic cases. It may also help bring some closure to grieving families.