?Terminal burrowing behaviour? ?a phenomenon of lethal hypothermia

Abstract

Between 1978 and 1994, 69 cases of death due to lethal hypothermia were examined in our Institute. In addition to the common findings associated with hypothermia we especially wanted to examine the so-called paradox reaction which refers to the undressing of persons in a state of severe (lethal) hypothermia. This is obviously the result of a peripheral vasodilatation effecting a feeling of warmth. In our material this paradoxical undressing occurred in 25% of the cases and nearly all exhibited an additional phenomenon which has not yet been described in the literature. Nearly all bodies with partial or complete disrobement were found in a position which indicated a final mechanism of protection i.e. under a bed, behind a wardrobe, in a shelf etc.. This is obviously an autonomous process of the brain stem, which is triggered in the final state of hypothermia and produces a primitive and burrowing-like behaviour of protection, as seen in (hibernating) animals. This phenomenon, which we refer to as "terminal burrowing behaviour", occurred predominantly with slow decreases in temperature and moderately cold conditions.

Hypothermia

“…The latter describes a phenomenon that may occur in late stages of general hypothermia where victims undress themselves due to a paradoxical sensation of warmth, most frequently in moderate temperatures between -5 and ?5°C [91][92][93][94][95]. The exact reason for this is not known.…”

“…Peripheral vasomotor failure and effects of hypothermia on the temperature-regulating centre in the hypothalamus have been proposed [17,43,96,97]. A body may be found underneath bushes or pieces of furniture, which is a feature of another phenomenon occurring in the later stages of hypothermia known as ''hide-and-die'' syndrome, which has been suggested to be either the result of confusion and/or of ancient reflexes similar to those of hibernating animals that make the victim ''seek shelter'' [95,98]. As a consequence of this victims may tip over furniture, creating disorder at the scene, which-especially in combination with paradoxical undressing-might raise suspicions of a violent crime [98,99].…”

Maggots reveal a case of antemortal insect infestation

“…Together with the forensic entomological results, it seems to be the most obvious scenario that the woman fell down, got unconscious, and died of lacking nutrition, water supply, as well as of a hypothermic state of some level [36]. Of course, other considerations might be also true such as that she has fallen after trying to urinate in the area of the gulley also explaining the position of the clothings of her lower body.…”

Wilderness medicine

“…"Paradoxic undressing" is thought to be caused by cutaneous vasodilation and alterations in cognition; "terminal burrowing" might be a primitive refl ex. [65][66][67] The basics of hypothermia resuscitation include prevention of further heat loss, rewarming, and support of physiologic processes. [68,69] Field research with healthy subjects and invasive monitoring has clarified the physiology of cooling and afterdrop.…”