Two Siblings with Recurrent Cardiorespiratory Arrest: Munchausen Syndrome by Proxy or Child Abuse?

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Abstract
The terms "Muenchausen syndrome by proxy" or "Polle syndrome" have been used to describe children who are victims of parentally induced or fabricated illness. Case histories of 2 siblings (a 7-mo.-old girl and a 4-yr-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 are reported. Polygraphic monitoring with hidden camera was used to determine that the episodes of cardiorespiratory arrest were parentally induced in the infant. The 4-yr-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 2 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.