Dead in the water: Epilepsy-related drowning or sudden unexpected death in epilepsy?

Epilepsia
Esma CihanDaniel Friedman

Abstract

Both drowning and sudden unexpected death in epilepsy (SUDEP) are diagnoses of exclusion with predominantly nonspecific autopsy findings. We hypothesized that people with epilepsy found dead in water with no clear sign of submersion could be misdiagnosed as SUDEP. All reported seizure-related deaths undergoing medicolegal investigation in three medical examiner's offices (New York City, Maryland, San Diego County) over different time periods were reviewed to identify epilepsy-related drownings and SUDEPs. Drowning cases that fulfilled inclusion criteria were divided into two groups according to the circumstances of death: definite drowning and possible drowning. The SUDEP group included two sex- and age (±2 years)-matched definite SUDEP/definite SUDEP plus cases for each drowning case. Of 1346 deaths reviewed, we identified 36 definite (76.6%) and 11 possible drowning deaths (23.4%), most of which occurred in a bathtub (72.3%). There were drowning-related findings, including fluid within the sphenoid sinuses, foam in the airways, clear fluid in the stomach content, and lung hyperinflation in 58.3% (21/36) of the definite drowning group, 45.5% (5/11) of the possible drowning group, and 4.3% of the SUDEP group (4/92). There was n...Continue Reading

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Dec 24, 2019·Experimental Neurology·Alexandra N PetrucciGordon F Buchanan
Jul 9, 2021·Pediatrics International : Official Journal of the Japan Pediatric Society·Masao YoshinagaNaoko Kashima
Aug 3, 2021·JAMA Neurology·Pavel KleinMichael R Sperling

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