[The autonomic nervous system in sudden infant death syndrome. Analysis of heart rate and sinusal variability on Holter monitoring of infants who died].

To evidence abnormality of cardiac control by the autonomic nervous system in the sudden infant death syndrome (SIDS) we retrospectively analysed the Holter recordings and cardiopneumograms of 19 infants (11 boys, 8 girls) of mean +/- SD age 2.3 +/- 1.5 months who had subsequently died of SIDS.

Night sleep heart rate patterns recorded by cardiopneumography at home in normal and at-risk for SIDS infants.

It has been reported that infants at higher than normal epidemiological risk for the sudden infant death syndrome (SIDS) have abnormal cardiac autonomic activity. A prospective work was performed using cardiopneumographic recordings (CPG) in order to evaluate heart rate (HR) and heart rate variability (HRV) patterns in sleeping normal control infants (C) and in infants at-risk for SIDS in their normal environment at home. One hundred appropriate-for-gestational age full-term infants were studied: 28 C, 48 SIDS siblings (SS), and 24 near-miss for SIDS (NM) within the first 2 weeks following the first detected apparent life-threatening event.

[Medical behavior and sudden infant death].

The authors recall some hypothesis about factors of risk which are acknowledged as possible element of SIDS and may receive a treatment: gastroesophageal reflux, vagal hyperexcitability and enzymatic deficit.

[Transcutaneous oxygen tension and apnea during sleep stages in normal infants and infants at risk for sudden infant death syndrome].

The relationship between chronic hypoxemia and sudden infant death syndrome (SIDS) has been reported by several authors. In order to study the influence of the apnea-time during a sleep state on transcutaneous oxygen tension (tcPO2), we have studied polygraphically 30 full-term infants (10 controls, 10 SIDS siblings and 10 near-miss for SIDS), aged from 5 to 13 weeks. No significant difference was observed either for apnea-time or tcPO2 between infant-groups studied in different sleep states.

Sudden infant death syndrome in a twin: a comparison of sibling histories.

To determine possible characteristics of infant victims of sudden death, we examined 114 items related to the pre- and postnatal histories of 42 pairs of twins one of whom died of sudden infant death syndrome (SIDS) leaving a surviving sibling. Interviews with the parents were conducted after the occurrence of SIDS, and the data were checked with records held by gynecologists and pediatricians. To evaluate the specificity of any factors, we studied a control group of 42 age- and sex-matched pairs of twins, both of whom survived the first year of life.

Effect of sleep position on transcutaneous oxygen tension in SIDS siblings.

To assess the influence of sleep position in sudden infant death syndrome siblings (SIDSS), we have studied 60 healthy SIDSS between the 1st and 3 + 4th month of life polygraphically. Infants were grouped according to postnatal age (1st, 2nd and 3 + 4th month) and sleep position (supine and prone). Transcutaneous oxygen tension (tcPO2) was continuously recorded and studied in each sleep state (active (AS) and quiet sleep (QS)) during the 1st and 2nd sleep cycle.

Respiratory pauses and periodic breathing assessed by cardio-pneumography in normal infants and in SIDS siblings.

450 cardio-pneumograms (CPG) were performed on two successive nights in 68 controls and 235 SIDS siblings. The number of respiratory pauses greater than or equal to 5 sec and greater than or equal to 10 sec (NP) and the time of periodic breathing (PB) were calculated per 100 minutes of recording. Recordings were arranged into five age groups corresponding to the 1st, 2nd, 3rd, 4th and 5th-6th month of life.

Neonatal electroencephalography during the first twenty-four hours of life in full-term newborn infants.

Analysis of 84 EEGs recorded during the first 24 hours of life in 80 full-term newborns admitted in intensive care unit for different reasons. - 35 died, 45 survived (normal outcome: 30, minor sequelae: 6, major sequelae: 9). Extremely abnormal EEGs (27 cases) demonstrated singly or in combination: electrical discharges - isoelectric activity (after 10 hours of life) - Permanent discontinuous activity with longest interval greater than 40 seconds, shortest interburst interval greater than 3 seconds, longest burst shorter than 6 seconds.

Are polygraphic and cardiopneumographic respiratory patterns useful tools for predicting the risk for sudden infant death syndrome? A 10-year study.

Between 1974 and 1984 we have studied 204 control infants (C) comparing them with 650 SIDS siblings (SS) and 146 near-miss for SIDS (NM). These 1,000 full-term infants were recorded by day polysomnography (DPSG; n = 417), night polysomnography (NPSG; n = 257) and cardiopneumography (CPG; n = 2,600). Records were visually analyzed.

Polysomnograms and cardiopneumograms in SIDS research.

Polysomnographic (PSG) and cardiopneumographic (CPG) recordings are commonly used in research on sudden infant death syndrome (SIDS). PSG and simultaneous CPG recordings were compared in order to clarify two practical problems: reliability of sleep state evaluation with CPG and comparability of the number of respiratory pauses evaluated by these two recording techniques. This comparison shows that: (1) evaluation of sleep states by CPG technique is only reliable for quiet sleep and (2) there was a significant difference in the number of pauses, the evaluation with PSG being systematically higher than with CPG.

[Paroxysmal vagal hypertonia in infants. Apropos of 14 cases].

Fourteen infants presenting with unexplained episodes of weakness or fainting were investigated by repeated Holter monitor recordings and oculocardiac reflexes (OCR). The recordings were then compared with those of 10 normal children in order to try to establish the criteria of vagal hyperreflexia. Results of OCR were collated with those of Holter: there was a good correlation between the length of the cardiac arrest on the OCR and the minimal instantaneous frequency and the maximal change of instantaneous frequency recorded on the Holter.

[Diagnoses to consider in newborn infants with inactive EEG tracings].

Thirty-one neonates without any electroencephalographic activity detectable on the first EEG before day 5 were studied. In the first group (20 neonates) the first EEG was performed on day 0. Signs of foetal and/or perinatal anoxia were observed.

Respiratory frequency during sleep in siblings of sudden infant death syndrome victims. A comparison with control, normal infants.

The present study was carried out on 76 polygraphic recordings performed on 38 siblings of sudden infant death syndrome victims and on 38 control (2 days to 18 weeks old) infants. Each sibling corresponded to a control infant according to gender, gestational age at birth and postnatal age criteria. We found that in siblings as in controls, respiratory frequency (RF) was higher in active sleep (AS) compared to quiet sleep (QS) state (P less than 0.

Sleep apneas in normal neonates and infants during the first 3 months of life.

Sleep polygraphic recording was carried out on 52 normal full-term babies. 16 infants were recorded at 2 - 7 days of age, 14 at 2 to 5 weeks, 13 at 6 to 9 weeks and 9 at 10 - 13 weeks. Central apneas of 2 sec and over were analysed in Active Sleep (AS), Quiet Sleep (QS) and Transitional Sleep (TS).

Respiratory pauses in normal infants and in siblings of victims of the sudden infant death syndrome.

Sleep polygraphic recording was carried out on 57 normal infants and on 100 SIDS siblings during morning naps between birth and the 4th month of life. Total sleep time and duration of sleep stages were determined. Central apnoeas of 2 sec and longer duration were analysed in AS, QS and IS.

[Convulsions in neonates. Clinical, electrographic, etiopathogenic and prognostic aspects].

121 cases of neonatal convulsions, including 79 cases of status epilepticus and 42 cases of isolated convulsions are studied. The great number of premature infants (40/121 newborns born before a gestational age of 37 weeks) must be pointed out. The clinical symptoms and EEG activity occurring during the first 24 hours following the onset of convulsions are analysed.

[Waking-sleeping transition in the newborn baby and in infants before the age of 3 months (author's transl)].

The mode of transition from waking to sleeping was studied using two methods: (1) by the simple observation of behavioural criteria (opening and closing of eyes, crying, motility), and in particular, rapid eye movements (REM); (2) from combined behavioural and polygraphic criteria (recorded REM, chin EMG, respiratory rhythm, EEG). This study shows that sleep may begin without complete eye closure, with half closed eyes or with brief, alternating opening and closing of the eyes. The modifications of the various polygraphic and behavioural parameters depend on the stage of sleep which is the outcome.

The prognostic value of the electroencephalogram in premature infants.

A retrospective analysis of 184 EEGs performed during the neonatal period was accomplished on 81 premature infants (gestational age less than or equal to 36 weeks). The neurological outcome of the 64 surviving infants, considered as normal or abnormal with minor or major sequelae, was compared with the neonatal EEGs which were graded as normal, moderately or markedly abnormal. Infants whose serial EEGs were normal during the neonatal period were usually normal at follow up or suffered minor sequelae.

[Post-natal respiratory disorders and hypothyroidism. Polygraphic study of a case].

A new-born baby with hypothyroidism showed only one clinical manifestation of the condition. There were repeated lasting attacks of apnoea, and periodic respiration was demonstrated by polygraphic recordings. These recordings, made during the waking periods and sleep, between the 10th day and 7th month, showed the evolution of the apnoea and periodic respiration as a function of the two treatments applied.

[Postnatal iodine excess with hypothyroidism and respiratory pauses. Danger of the cutaneous application of iodine chemicals].

A hypothyroidism with moderate goiter was discovered in a newborn presenting with repeated apnoea indicating a severe risk of sudden death. The mother was given no iodine-rich drug. However, the child was submitted to several large applications of iodized alcohol to the skin for numerous blood samplings.

[Electroencephalographic study of a case of neonatal herpes encephalitis (author's transl)].

This report describes the serial E.E.G.

[An electroencephalographic study of neonatal subdural haemorrhage (author's transl)].

Subdural haemorrhages in the neonate are still rarely recognised clinically. This study was carried out using E.E.