@article{ref1,
title="Fatal hyponatremic encephalopathy as a result of child abuse from forced exercise",
journal="American journal of forensic medicine and pathology",
year="2015",
author="Moritz, Michael L. and Lauridson, James R.",
volume="37",
number="1",
pages="7-8",
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.<p /> <p>Language: en</p>",
language="en",
issn="0195-7910",
doi="10.1097/PAF.0000000000000212",
url="http://dx.doi.org/10.1097/PAF.0000000000000212"
}