Abstract

Medical investigators in the 21 st century have increasingly focused on neurotransmitter abnormalities in the medulla oblongata as the primary etiology of Sudden Infant Death Syndrome(1) and also as the etiology of sudden unexpected deaths that occur in adults with Multiple System Atrophy(2) – serotonin is the problem in both instances.Investigators have also reported numerous cases in which the presence of a very small anatomical medullary brain lesion, like a plaque of demyelinated white matter(3), was associated with sudden unexpected death(4,5) – and in all cases the lesions were without mass effect or hemorrhage(6). Many such medullary lesions have otherwise produced only minor clinical symptoms and have in themselves been previously considered relatively harmless – in cases where they have been known to be present.Many victims have been considered healthy prior to sudden death, and the medullary brain lesions were often incidental discoveries at autopsy, with no other causes of death identified.

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