A 23-day-old male infant presents to the emergency department with apnea.

After being fed and burped, the baby suddenly developed apnea. Emergency medical services were called after a short delay when the father, the primary caregiver, had called his mother and the baby’s mother at work. The duration of apnea was unknown. When the paramedics could not discern a heart rate, they started cardiopulmonary resuscitation and administered epinephrine via an intraosseous line. In the emergency department, a heart rate was obtained after 1 minute of resuscitation, and the infant was transferred promptly to the intensive care unit. The parents reported episodes of flexor posturing with eyes rolling back and tremulousness since birth that they described as seizures.

Temperature: 96.6°F (35.9° C)

Heart rate: 137 beats/min

Blood pressure: 85/42 mm Hg

Respiratory rate: 12 breaths/min

Oxygen saturation: 100% on 0.4 FiO2

General examination: The child was intubated and placed on...

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