Differential Diagnosis for Repeated Apneas in a 2-Month-Old
Single Most Likely Diagnosis
- Apnea of Prematurity: This is the most common cause of apnea in infants, especially in those born preterm. It is due to the immaturity of the brain's respiratory control.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD can cause apnea in infants due to the irritation of the esophagus and subsequent reflexive cessation of breathing.
- Infection: Respiratory or gastrointestinal infections can lead to apnea in infants, either through direct effects on the respiratory system or through systemic illness.
- Congenital Heart Disease: Certain congenital heart defects can lead to apnea due to decreased cardiac output or increased pulmonary pressure.
Do Not Miss Diagnoses
- Child Abuse: Non-accidental trauma, including shaken baby syndrome, can cause apnea and must be considered to ensure the infant's safety.
- Congenital Central Hypoventilation Syndrome: A rare condition characterized by impaired ventilatory response to carbon dioxide, which can present with apnea.
- Spinal Muscular Atrophy: A genetic disorder affecting the nerve cells responsible for controlling voluntary muscle movement, which can lead to respiratory failure and apnea.
Rare Diagnoses
- Narcotic-Induced Apnea: If the mother is on narcotics, it can cause apnea in the newborn due to the transfer of these substances through breast milk or placenta.
- Metabolic Disorders: Certain metabolic disorders, such as disorders of fatty acid oxidation, can present with apnea among other symptoms.
- Brainstem or CNS Abnormalities: Structural abnormalities in the brainstem or central nervous system can affect the regulation of breathing, leading to apnea.