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Thread: Definition and Causes of Apparent Life-Threatening Events (ALTE)

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    Arrow Definition and Causes of Apparent Life-Threatening Events (ALTE)

    Definition and Causes of Apparent Life-Threatening Events (ALTE)

    Definition of ALTE

    By definition, an ALTE refers to a sudden event, often characterized by apnea or other abrupt changes in the child's behavior. Symptoms of an ALTE include one or more of the following: apnea, change in color or muscle tone, coughing, or gagging.

    Diagnoses Made in Children with an Apparent Life-Threatening Event



    * Idiopathic (approximately 50 percent)

    * Gastrointestinal - GI (most common, up to 50 percent of diagnosed cases)

    • Gastroesophageal reflux
    • Gastric volvulus
    • Intussusception
    • Swallowing abnormalities
    • Other GI abnormalities
    * Neurologic (approximately 30 percent)

    • Seizure disorder
    • Febrile seizure
    • CNS bleeding
    Neurologic conditions affecting respiration (Budd-Chiari syndrome, hindbrain malformation, brainstem malformation)

    • Vasovagal reflexes
    • Hydrocephalus
    • CNS infection
    • Ventriculoperitoneal shunt malfunction
    • Malignancy
    * Respiratory (approximately 20 percent)

    • Respiratory compromise from infection, respiratory syncytial virus, pertussis, mycoplasma, croup, other pneumonias
    • Obstructive sleep apnea
    • Breath-holding spells
    • Conditions affecting respiratory control (prematurity, central hypoventilation)
    • Vocal cord abnormalities, adenoid vegetations
    • Laryngotracheomalacia
    • Airway obstruction resulting from congenital abnormalities
    • Foreign-body aspiration
  2. * Cardiac (up to 5 percent)

    • Arrhythmia
    • Long QT syndrome
    • Wolff-Parkinson-White syndrome
    • Congenital heart disease

    • Myocarditis
    • Cardiomyopathy


    * Metabolic abnormalities (less than 5 percent)

    • Inborn errors of metabolism
    • Endocrine, electrolyte disorders
    • Other infections
    • Urinary tract infection
    • Sepsis
    * Child abuse (less than 5 percent)

    • Munchausen syndrome by proxy (suffocation, intentional salt poisoning, medication overdose, physical abuse, head injury)
    • Smothering (unintentional or intentional)
    * Other

    • Food allergy (uncommon)
    • Anaphylaxis
    • Medication (prescription, over the counter, herbal remedies)
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    tansssssss dear

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    thank youu

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