Evaluation of sudden death in epilepsy

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Schwender LA and Troncoso JC (1986) Evaluation of sudden death in epilepsy. Am J Forensic Med Pathol 7:4 283–7.

Link to Article

Abstract: Records of the Office of the Chief Medical Examiner of the State of Maryland were reviewed for all cases of natural deaths due to epilepsy occurring in 1981 and 1982. Cases involving unclear seizure history, alcoholism, or other superimposed disorders were excluded. Twenty-nine cases were accepted and analyzed with respect to age, race, sex, circumstances of death, neuropathology, and anticonvulsant therapy. Most cases involved black males, the median age at death was 26 years, and the vast majority died in bed or in the bedroom. Less than half of these individuals had neuropathological lesions. Most had detectable levels of anticonvulsants in post-mortem blood; more than half the decedents with detectable levels of phenobarbital showed therapeutic levels of this drug.

Context

  • Retrospective review of causes of death in Maryland, US over a 2 year period. 29 cases of death ‘due to epilepsy’ were identified. Most cases involved African-American males and most deaths were in bed or in the bedroom. In contrast to other studies evaluating postmortem blood samples, many of the deceased had therapeutic AED levels. The population in this early study is similar to that reported by Leestma et al. This may reflect a selection bias influencing the demographics of SUDEP cases diagnosed by medical examiners.

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