Fatal hyponatremic encephalopathy as a result of child abuse from forced exercise

Date

2016

Journal Title

Journal ISSN

Volume Title

Publisher

The American journal of forensic medicine and pathology

Abstract

We report a case of fatal hyponatremic encephalopathy in a child who was forced to exercise as a form of punishment. A 9-year-old girl with attention-deficit/hyperactivity disorder was forced to run repeated 50-ft sprints to the point of exhaustion by her grandmother as punishment for taking candy from a classmate. After more than 3 hours of forced running, the child collapsed, began to vomit, and had repeated clonic seizures. Upon presentation to the emergency department, she was nonresponsive with a Glasgow Coma Scale score of 11 and had noncardiogenic pulmonary edema with serum sodium of 117 mEq/L. She was treated with antiepilectic medications and transferred to a university children’s hospital where she later died. On postmortem examination, she was found to have massive cerebral edema with transtentorial herniation and pulmonary edema. Her clinical presentation closely resembled exercise-associated hyponatremic encephalopathy seen in adult endurance athletes. This appears to be the first report of fatal exercise-associated hyponatremia in a child. (Author Abstract)

Description

Keywords

child abuse, physical abuse, fatality, case report

Citation

Moritz, M. L., & Lauridson, J. R. (2016). Fatal hyponatremic encephalopathy as a result of child abuse from forced exercise. The American journal of forensic medicine and pathology, 37(1), 7-8.

DOI