PEDIATRICS Vol. 71 No. 5 May 1983, pp. 715-720
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Two Siblings with Recurrent Cardiorespiratory Arrest: Munchausen Syndrome by Proxy or Child Abuse?

Carol Lynn Rosen MD1, James D. Frost Jr MD1, Tim Bricker MD1, Jay D. Tamow MD1, Paul C. Gillette MD1, and Susan Dunlavy RN1

1 From the Departments of Pediatrics, Neurology, and Psychiatry, Baylor College of Medicine, Houston

The terms "Munchausen syndrome by proxy" or "Polle syndrome" have been used to describe children who are victims of parentally induced or fabricated illness. This report gives case histories of two siblings (a 7-month-old girl and a 4-year-old boy) with recurrent episodes of cardiorespiratory arrest that were induced by a mother who skillfully resuscitated the children and who demonstrated model parental behavior. Polygraphic monitoring with hidden camera was used to determine that the episodes of cardiorespiratory arrest were parentally induced in the infant. The 4-year-old sibling had previously undergone multiple diagnostic and surgical procedures. After the diagnosis was made in the infant, and the mother was no longer permitted to be alone with the children, neither child had further episodes. A psychologic profile of the mother is presented, and special features of these two and other cases in the literature are reviewed. These cases represent a form of child abuse. A parentally induced illness should be considered in the differential diagnosis of unusual illnesses with bizarre features, even when the parent's behavior appears exemplary.

Key Words: child abuse • polygraphic monitoring • cardiorespiratory arrest • Munchausen syndrome by proxy • Polle syndrome

Submitted on June 25, 1982
Accepted on August 3, 1982




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