Seizures: A Video Clue to the Mystery of Sudden Toddler Deaths

BEDROOM, BEL AIR, MARYLAND – The last bedtime of 17-month-old Hayden Fell’s life was heartbreakingly normal. Crib video shows the toddler in pajamas playing happily as his parents and sister sang “Wheels on the Bus” with his twin brother. The next morning, Hayden’s dad couldn’t wake him. The tot had become one of several hundred seemingly healthy U.S. toddlers and preschoolers each year who suddenly die in their sleep and autopsies can’t tell why. But Hayden’s crib cam was recording all night — and offered a clue.

Seizures during sleep are a potential cause of at least some cases of sudden unexplained death in childhood, or SUDC, researchers at NYU Langone Health reported Thursday after analyzing home monitoring video that captured the deaths of seven sleeping toddlers. SUDC is the term when these mysterious deaths occur any time after a child’s first birthday. Little is known about SUDC but some scientists have long suspected seizures may play a role.

The new study offers the first direct evidence of a seizure link. Five of the toddlers died shortly after movements deemed to be a brief seizure by a team of forensic pathologists, a seizure specialist, and a sleep specialist. The recordings can’t prove fevers triggered the seizures but researchers noted several toddlers had signs of mild infections.

SUDC is estimated to claim over 400 lives a year in the U.S. Most occur during sleep. And just over half, about 250 deaths a year, are in 1- to 4-year-olds. Hayden experienced his first seizure shortly before his first birthday, when a cold-like virus sparked a fever. Additional mild bugs triggered several more but Hayden always rapidly bounced back — until the night in November 2022 when he died.

Other recent studies have hunted genetic links to SUDC — finding that some children harbored mutations in genes associated with heart or brain disorders, including irregular heartbeats and epilepsy. Heart problems, including those mutations, couldn’t explain the deaths of the toddlers in the video study, Devinsky said. He cautioned that far more research is needed but said epilepsy patients sometimes experience difficulty breathing after a seizure that can lead to death — and raised the prospect that maybe some SIDS deaths could have seizure links, too.

In conclusion, SUDC claims the lives of hundreds of seemingly healthy U.S. toddlers and preschoolers each year. The study offers the first direct evidence of a seizure link, shedding light on potential causes for these mysterious deaths. It is clear that further research is needed to fully understand and prevent SUDC.