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J R Soc Med 2003;96:102-103
doi:10.1258/jrsm.96.2.102-b
© 2003 Royal Society of Medicine

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J R Soc Med 2003;96:102-103
© 2003 The Royal Society of Medicine

Shaken baby syndrome

John B P Stephenson

Cruachan, Bowmore, Isle of Islay, PA43 7HR, UK

With the December 2002 issue of the JRSM I received a colour brochure advertising the European Conference on Shaken Baby Syndrome, to be held in Edinburgh in May 2003. The chief sponsor is the National Center on Shaken Baby Syndrome, USA, but supporters include the RSM. Shaken baby syndrome (or shaken impact syndrome) is a hypothetical condition, albeit believed in by some with a religious passion. In the hurly-burly of full-time paediatric neurological practice I used to believe in it myself; however, within the past two years publications from several centres have critically questioned the assumptions underlying the concept and the diagnosis1,2,3,4,5,6,7. If the purpose of the conference is scientific enquiry and rational discourse, it is surprising that the authors of these publications are entirely absent from the list of invited speakers.

REFERENCES

  1. Plunkett J. Fatal pediatric head injuries caused by short-distance falls. Am J Forensic Med Pathol2001; 22:1 -12[CrossRef][Medline]

  2. Geddes JF, Hackshaw AK, Vowles GH, Nickols CD, Whitwell HL. Neuropathology of inflicted head injury in children. I. Patterns of brain damage. Brain2001; 124:1290 -8[Abstract/Free Full Text]

  3. Clark BJ. Retinal hemorrhages: evidence of abuse or abuse of evidence? Am J Forensic Med Pathol2001; 22:415 -16[Medline]

  4. Clark BJ, Adams GG, Luthert PJ. Retinal haemorrhages in infant head injury. Brain2002; 125:677 -8[Free Full Text]

  5. Uscinski R. Shaken baby syndrome: fundamental questions. Br J Neurosurg2002; 16:217 -19[CrossRef][Medline]

  6. Ommaya AK, Goldsmith W, Thibault L. Biomechanics and neuropathology of adult and paediatric head injury. Br J Neurosurg2002; 16:220 -42[CrossRef][Medline]

  7. Vinchon M, Noizet O, Defoort-Dhellemmes S, Soto-Ares G, Dhellemmes P. Infantile subdural hematomas due to traffic accidents. Pediatr Neurosurg 2002;37:245 -53[CrossRef][Medline]

Authors' reply

Marilyn Sandberg Robert Minns   Ronald G Barr

Planning Committee, European Conference on Shaken Baby Syndrome

As Professor Stephenson is aware from his own paediatric neurological practice, there are too many children who have been shaken and who have a constellation of characteristic neurological deficits. Over the years, infants and children who present with these features have come to be referred to as patients with ‘shaken baby syndrome’ (or shaken impact syndrome). In addition, much more has been learned about who the perpetrators are likely to be, possible prevention strategies, characteristics of lesions that are or are not typical for the syndrome, legal ramifications, long-term outcomes and so on. Professor Stephenson is also correct in pointing out that the specific pathogenesis remains the subject of ongoing investigation and attempts at modelling—a process of inquiry that has occurred for many other syndromes in the history of medicine. We could not agree more that belief with a religious passion has nothing to do with the relevance of the syndrome or our current understanding of it. There are many serious scientists and non-scientists who are making important contributions to our increasing understanding of the syndrome, who critically assess the assumptions underlying the concept and the diagnosis, and who will be presenting at the conference (for list of speakers see [www.dontshake.com]). Dr Jennian Geddes1, one of those listed by Professor Stephenson, was invited as a keynote speaker but declined the invitation.

While this conference will not solve all of the outstanding questions concerning the syndrome, it will be an opportunity for ‘scientific enquiry and rational discourse’. We hope that Professor Stephenson and anyone else with an interest in the syndrome will take the opportunity to contribute.

REFERENCES

  1. Geddes JF, Hackshaw AK, Vowles GH, Nickols CD, Whitwell HL. Neuropathology of inflicted head injury in children. I. Patterns of brain damage. Brain2001; 124:1290 -8


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This Article
Right arrow Full Text (PDF)
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