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Compensation Issues in Grand Mal Epilepsy

A case of infantile xanthomatous cardiomyopathy, presenting as a cot death, is described. The literature is reviewed and the aetiology of the lesion discussed. INTRODUCTION Cot death is a very emotive subject. In Ayrshire (population 450,000 approximately) between four and 22 cases occur per annum. A very small proportion of these are 'explained', e.g, acute epiglottitis, meningococcal septicaemia, haemophilus pneumonia, coxsackie myocarditis and congenital heart lesions. Failure to establish a cause of death is essential to the diagnosis of Sudden Infant Death Syndrome (SIOS). The case described in this paper was considered on gross examination to be SIDS but histological examination 'explained' the death. CASE REPORT A female infant, aged 14 months, the youngest of a family of four, was found dead in her cot at 8 a.m. by her mother. On the previous day the child had been rather listless and chesty and had refused solid food at lunch-time and at evening meal. She was given a 7 oz. milk feed and put to bed. The parents retired to bed at 11.40 p.m. and finding the child awake and lively the mother gave her another 3 oz. milk feed and again put her to bed, where she was seen to fall asleep. This baby was born at full-term by spontaneous vertex delivery. One week after birth the infant was admitted to the local childrens hospital because of a 'convulsion', thought to have been caused by slow healing and resultant infection of the umbilical cord. She had recurrent respiratory problems from birth until aged 3 months, when she was again admitted to the children's hospital with a chest infection. Thereafter the baby appeared to thrive, was lively and had a good appetite, although was said to be delicate in build and stature. The police and a police surgeon investigated the death and found no evidence of injury on the child. The bedroom was untidy and poorly decorated but was warm, being heated by an electric convector heater. An autopsy examination was carried out at the request of the Procurator Fiscal. The body was that of a well-nourished female infant.