Sudden Unexplained Death and Injury in Epilepsy

Ficker, David M.

doi:10.1111/j.1528-1157.2000.tb01519.x

Cited by 140 publications

(100 citation statements)

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“…Olgumuzda ileri derecede beyin ödemi tespit edilmiflken literatürde orta derecede beyin ödeminden bahsedilmektedir (8,12). Baz› çal›flmalarda; sa¤ kalp yetmezli¤i bulgular›n› düflün-dürecek flekilde karaci¤er a¤›rl›¤›n›n artm›fl oldu¤u ve venöz konjesyonlu oldu¤u tespit edilmiflken, olgumuzda ödem d›fl›nda baflka bir bulgu tespit edilmemifltir (6,14,15).…”

Section: Tartifimaunclassified

Epilepsisi Olan Hastada Ani ve Beklenmedik Ölüm Olgu Sunumu

Özer¹,

Yurtman²,

Bütün³

2006

Bull Leg Med

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Epilepsi hastas› bir kiflide ani ölüm görülme olas›l›¤›, normal popülasyonda ani ölüm görülme olas›l›¤›ndan 24 kat daha fazla olmaktad›r.Olgumuz 40 yafl›nda epilepsi hastas› olup, evinde ölü bulundu¤unda alt› ayl›k hamileydi. Ölü muayenesi ve otopsi yap›l-mas›na ra¤men, ölüm nedeni olabilecek bir patoloji veya epilepsi krizi geçirdi¤inin delili olabilecek herhangi bir travma izi tespit edilmemifltir. Toksikolojik incelemede de ölüme neden olabilecek bir madde tespit edilememifltir.Adli tahkikat dosyas›ndaki ölü muayene, otopsi raporu, olay yeri incelemesi ve t›bbi öyküsü birlikte de¤erlendirildi¤inde, ölüm nedeni epilepsi olan hastada ani beklenmedik ölüm (EHABÖ) kriterlerine göre kesin EHABÖ kategorisinde oldu¤u kanaatine var›lm›flt›r.Bu olgu, epilepsi hastas› olan kiflilerin otopsilerine dikkati çekmek ve bu tip olgulara adli t›bbi yaklafl›m ilkelerinin tart›-fl›lmas› amac›yla sunulmufltur.Anahtar kelimeler: Epilepsi, ani ölüm, EHABÖ, hamilelik SUMMARYThe probability of sudden death for patient with epilepsy is almost 24 times higher than for someone without epilepsy. Our case was a 40 years old woman with epilepsy who was six months pregnant when she was dead at her home. Although external examination and autopsy were performed, no pathological signs indicating a cause for death or no signs of trauma indicating an epileptic seizure were observed. Nothing was found in toxicological analysis to reveal a reason for death.When external examination, autopsy report, scene investigation and medical history in forensic investigation folder are evaluated together, reason of death is thought to be definete sudden unexpected death in epileptic patient according to SU-DEP criteria.This case is presented to attract attention to autopsies of patients with epilepsy and to discuss the principles of medicolegal approach to these cases.

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Section: Tartifimaunclassified

Epilepsisi Olan Hastada Ani ve Beklenmedik Ölüm Olgu Sunumu

Özer¹,

Yurtman²,

Bütün³

2006

Bull Leg Med

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“…Possible SUDEP is defined by 1, 2 and 3 as above, but an alternative explanation of death is present. Usually only definite and probable cases are used to study SUDEP cases 6 . The other categories include fatal status epilepticus, neurocysticercosis, patients who were drunk in the occasion of the death or who were under life-threatening conditions.…”

Section: Methodsmentioning

confidence: 99%

“…SUDEP was defined as sudden occurrence of death in a person with epilepsy in the absence of a reasonable anatomic or toxicological explanation for death. Other causes of sudden death, such as cardiac ischemia, pulmonary embolus, cerebral hemorrhage, need to be excluded before a case is determined to be SUDEP, which usually requires a postmortem examination 6 . SUDEP has been reported to be responsible for 2 to 17 % of all deaths in patients with epilepsy 6 .…”

mentioning

confidence: 99%

“…Other causes of sudden death, such as cardiac ischemia, pulmonary embolus, cerebral hemorrhage, need to be excluded before a case is determined to be SUDEP, which usually requires a postmortem examination 6 . SUDEP has been reported to be responsible for 2 to 17 % of all deaths in patients with epilepsy 6 . Because of a poor understanding and therefore reporting of SUDEP, it is possible that in the absence of any clear cause, death may have been (falsely) ascribed to either status epilepticus, asphyxia or cardiorespiratory arrest 2 .…”

mentioning

confidence: 99%

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Sudden unexpected, unexplained death in epilepsy autopsied patients

Antoniuk

Oliva

Bruck

et al. 2001

Arq. Neuro-Psiquiatr.

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Sudden unexpected, unexplained death in epilepsy (SUDEP) has been reported to be responsible for 2 to 17% of all deaths in patients with epilepsy. This study was conducted to determine the circumstances of SUDEP and the autopsy findings in these patients. Fifty-three individuals whose cause of death was related to epilepsy were identified and in 30 cases relatives or friends were interviewed about the circumstances of death and other information which allowed to classify the patients as SUDEP or not. The death certificates were also reviewed. We found 20 cases of SUDEP. Most of them were found dead lying on the bed with no evidence of seizure event, and most of them had pulmonary and/or cerebral edema as the cause of death. The incidence and the risk of SUDEP can only be fully ascertained if all sudden deaths had postmortem examination. Consensus in certifying SUDEP cases would allow better accuracy in national mortality rate.KEY WORDS: sudden death, epilepsy, circumstances of death, pulmonary edema.Morte súbita, inexplicada e inesperada em epilepsia: pacientes autopsiados RESUMO Morte súbita inexplicada e inesperada em epilepsia (SUDEP) é responsável por 2 a 17% das mortes em pacientes epilépticos. Este estudo visa determinar as circunstâncias de SUDEP e os achados de autópsia destes pacientes. Foram identificados 53 pacientes cuja causa de morte foi associada a crise epiléptica; em 30 destes, parentes ou amigos foram entrevistados quanto às circunstâncias das mortes e outros aspectos. Também foram revisados os certificados de óbito destes pacientes. Foram encontrados 20 casos de SUDEP. A maioria foi encontrada morta na sua cama por parentes, sem evidência de crise convulsiva, e a causa de morte foi edema cerebral e\ou pulmonar. A incidência e o risco relativo de SUDEP só podem ser adequadamente definidos se houver autópsia em todas as pessoas que morrem subitamente. Um consenso sobre SUDEP permitiria maior acurácia aos dados de mortalidade nacional. PALAVRAS-CHAVE: morte súbita, epilepsia, circunstâncias de morte, edema pulmonar.

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“…The majority of the patients suffer from unpredictable, persistent and frequent seizures which limit the independence of an individual, increase the risk of serious injury and mobility, and result in both social isolation and economic hardship (Friedman & Gilliam, 2010). In addition, the patients with epilepsy have an increased mortality risk of approximately 2 to 3 times that of the general population (Ficker, 2000). The first line of treatment for epilepsy is with multiple anti-epileptic drugs and it is effective in about 70% of the cases.…”

Section: Introductionmentioning

confidence: 99%