Brief resolved unexplained event

Brief resolved unexplained event (BRUE), previously apparent life-threatening event (ALTE), is a medical term in pediatrics that describes an event that occurs during infancy. The event is noted by an observer, typically the infant's caregiver. It is characterized by one or more concerning symptoms such as change in skin color, lack of breathing, weakness, or poor responsiveness.^[1] By definition, by the time they are assessed in a healthcare environment they must be back to normal without obvious explanation after the clinician takes the appropriate clinical history and physical examination.^[2]

The American Academy of Pediatrics (AAP) clarified the use of both terms in a 2016 consensus statement that recommended the term BRUE be used whenever possible as it is more specifically defined. Thus, it is more useful for assessing risk of further events. The cause for BRUEs is often unknown, although some of the more common causes include gastroesophageal reflux, seizure, and child maltreatment. Evaluation after an ALTE or BRUE is diagnostically important, as some events represent the first sign or symptom of an underlying medical condition.^[1] In most cases, assuming the infants are otherwise healthy and no underlying medical issue is found, the infants who have a BRUE are unlikely to have a second event and have an even smaller risk of death.^[3]