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Difficulty in diagnosis; epileptic deaths

Year 2014, Volume: 4 Issue: 2, 59 - 63, 01.08.2014

Rıza Yılmaz Sinem Akat Sema Demircin Bahadır Kumral Serhat Gurpinar Erbil Gozukirmizi Ali Yildirim Erdal Ozer

Abstract

People with epilepsy have an increased incidence of sudden unexpected death compared with the general population. Epilepsy is not a uniform clinical presentation and the ratio of premature mortality largely depends on the underlying etiologic factors. Mortality in cases with epilepsy can be classified as deaths attributable to epilepsy and unrelated deaths with the epilepsy. Mortality as sudden unexpected death in epileptic patients (SUDEP), status epilepticus (SE), suicide, and accidents are considered to be epilepsy-related. In this study, we examined all files of the cases sent to the First Specialization Board of the Council of Forensic Medicine between the 2000 and 2005 for determination of the cause and the manner of death. The causes of deaths of 28 cases were re-evaluated according to the recent information. Of the 28 cases included in study 18 were male and 10 were female, the mean age was 29. As a result we have defined that 20 cases had died as SUDEP and four cases were SE (n=4). Remaining deaths were due to conditions possibly related to epileptic disease according to their previously recorded medical history and documents of postmortem examination and investigation.

The aim of our study was to detect the reasons and mechanisms of death in persons with known epilepsy according to the autopsy findings, the medical documents and the situations in which death occurred.

Keywords

epilepsy death forensic medicine.

References

  • Cockerell, O.C., et al., Mortality from epilepsy: results from a prospective population-based study. Lancet, 1994. 344(8927): p. 918-21.
  • Olafsson, E., W.A. Hauser, and G. Gudmundsson, Long-term survival of people with unprovoked seizures: a population-based study. Epilepsia, 1998. 39(1): p. 89-92.
  • Loiseau, J., M.C. Picot, and P. Loiseau, Short-term mortality after a first epileptic seizure: a population-based study. Epilepsia, 1999. 40(10): p. 1388-92.
  • Lindsten, H., L. Nystrom, and L. Forsgren, Mortality risk in an adult cohort with a newly diagnosed unprovoked epileptic seizure: a population-based study. Epilepsia, 2000. 41(11): p. 1469-73.
  • Lhatoo, S.D. and J.W. Sander, Cause-specific mortality in epilepsy. Epilepsia, 2005. 46 Suppl 11: p. 36-9.
  • Nashef, L., J.F. Annegers, and S.W. Brown, Introduction and overview. Sudden unexpected death in epilepsy. Epilepsia, 1997. 38(11 Suppl): p. S1-2.
  • Nashef, L., Sudden unexpected death in epilepsy: terminology and definitions. Epilepsia, 1997. 38(11 Suppl): p. S6-8.
  • Nashef, L. and S.D. Shorvon, Mortality in epilepsy. Epilepsia, 1997. 38(10): p. 1059-61.
  • Earnest, M.P., et al., The sudden unexplained death syndrome in epilepsy: demographic, clinical, and postmortem features. Epilepsia, 1992. 33(2): p. 310-6.
  • Kloster, R. and T. Engelskjon, Sudden unexpected death in epilepsy (SUDEP): a clinical perspective and a search for risk factors. J Neurol Neurosurg Psychiatry, 1999. 67(4): p. 439-44.
  • Nei, M., et al., EEG and ECG in sudden unexplained death in epilepsy. Epilepsia, 2004. 45(4): p. 338-45.
  • Lathers, C.M. and P.L. Schraeder, Verbal autopsies and SUDEP. Epilepsy Behav, 2009. 14(4): p. 573-6.
  • Schraeder, P.L., et al., Coroner and medical examiner documentation of sudden unexplained deaths in epilepsy. Epilepsy Res, 2006. 68(2): p. 137-43.
  • Terrence, C.F., G.R. Rao, and J.A. Perper, Neurogenic pulmonary edema in unexpected, unexplained death of epileptic patients. Ann Neurol, 1981. 9(5): p. 458-64.
  • Kenneback, G., et al., Changes in arrhythmia profile and heart rate variability during abrupt withdrawal of antiepileptic drugs. Implications for sudden death. Seizure, 1997. 6(5): p. 369-75.
  • Nilsson, L., et al., Antiepileptic drug therapy and its management in sudden unexpected death in epilepsy: a case-control study. Epilepsia, 2001. 42(5): p. 667-73.
  • So, E.L., M.C. Sam, and T.L. Lagerlund, Postictal central apnea as a cause of SUDEP: evidence from near-SUDEP incident. Epilepsia, 2000. 41(11): p. 1494-7.
  • Tellez-Zenteno, J.F., L.H. Ronquillo, and S. Wiebe, Sudden unexpected death in epilepsy: evidence-based analysis of incidence and risk factors. Epilepsy Res, 2005. 65(1-2): p. 101-15.
  • Chin, R.F., B.G. Neville, and R.C. Scott, A systematic review of the epidemiology of status epilepticus. Eur J Neurol, 2004. 11(12): p. 800-10.
  • Wu, Y.W., et al., Incidence and mortality of generalized convulsive status epilepticus in California. Neurology, 2002. 58(7): p. 1070-6.
  • Zielinski, J.J., Epilepsy and mortality rate and cause of death. Epilepsia, 1974. 15(2): p. 191-201.
  • Hauser, W.A., J.F. Annegers, and L.R. Elveback, Mortality in patients with epilepsy. Epilepsia, 1980. 21(4): p. 399-412.
  • Mohanraj, R., et al., Mortality in adults with newly diagnosed and chronic epilepsy: a retrospective comparative study. Lancet Neurol, 2006. 5(6): p. 481-7.
  • Ding, D., et al., Premature mortality in people with epilepsy in rural China: a prospective study. Lancet Neurol, 2006. 5(10): p. 823-7.
  • Shackleton, D.P., et al., Survival of patients with epilepsy: an estimate of the mortality risk. Epilepsia, 2002. 43(4): p. 445-50.
  • Tennis, P., et al., Cohort study of incidence of sudden unexplained death in persons with seizure disorder treated with antiepileptic drugs in Saskatchewan, Canada. Epilepsia, 1995. 36(1): p. 29-36.

Difficulty in diagnosis; epileptic deaths

Year 2014, Volume: 4 Issue: 2, 59 - 63, 01.08.2014

Rıza Yılmaz Sinem Akat Sema Demircin Bahadır Kumral Serhat Gurpinar Erbil Gozukirmizi Ali Yildirim Erdal Ozer

Abstract

People with epilepsy have an increased incidence of sudden unexpected death compared with the general population. Epilepsy is not a uniform clinical presentation and the ratio of premature mortality largely depends on the underlying etiologic factors. Mortality in cases with epilepsy can be classified as deaths attributable to epilepsy and unrelated deaths with the epilepsy. Mortality as sudden unexpected death in epileptic patients (SUDEP), status epilepticus (SE), suicide, and accidents are considered to be epilepsy-related. In this study, we examined all files of the cases sent to the First Specialization Board of the Council of Forensic Medicine between the 2000 and 2005 for determination of the cause and the manner of death. The causes of deaths of 28 cases were re-evaluated according to the recent information. Of the 28 cases included in study 18 were male and 10 were female, the mean age was 29. As a result we have defined that 20 cases had died as SUDEP and four cases were SE (n=4). Remaining deaths were due to conditions possibly related to epileptic disease according to their previously recorded medical history and documents of postmortem examination and investigation.

The aim of our study was to detect the reasons and mechanisms of death in persons with known epilepsy according to the autopsy findings, the medical documents and the situations in which death occurred.

 

Key Words: epilepsy, death, forensic medicine

Keywords

epilepsi ölüm adli tıp

References

  • Cockerell, O.C., et al., Mortality from epilepsy: results from a prospective population-based study. Lancet, 1994. 344(8927): p. 918-21.
  • Olafsson, E., W.A. Hauser, and G. Gudmundsson, Long-term survival of people with unprovoked seizures: a population-based study. Epilepsia, 1998. 39(1): p. 89-92.
  • Loiseau, J., M.C. Picot, and P. Loiseau, Short-term mortality after a first epileptic seizure: a population-based study. Epilepsia, 1999. 40(10): p. 1388-92.
  • Lindsten, H., L. Nystrom, and L. Forsgren, Mortality risk in an adult cohort with a newly diagnosed unprovoked epileptic seizure: a population-based study. Epilepsia, 2000. 41(11): p. 1469-73.
  • Lhatoo, S.D. and J.W. Sander, Cause-specific mortality in epilepsy. Epilepsia, 2005. 46 Suppl 11: p. 36-9.
  • Nashef, L., J.F. Annegers, and S.W. Brown, Introduction and overview. Sudden unexpected death in epilepsy. Epilepsia, 1997. 38(11 Suppl): p. S1-2.
  • Nashef, L., Sudden unexpected death in epilepsy: terminology and definitions. Epilepsia, 1997. 38(11 Suppl): p. S6-8.
  • Nashef, L. and S.D. Shorvon, Mortality in epilepsy. Epilepsia, 1997. 38(10): p. 1059-61.
  • Earnest, M.P., et al., The sudden unexplained death syndrome in epilepsy: demographic, clinical, and postmortem features. Epilepsia, 1992. 33(2): p. 310-6.
  • Kloster, R. and T. Engelskjon, Sudden unexpected death in epilepsy (SUDEP): a clinical perspective and a search for risk factors. J Neurol Neurosurg Psychiatry, 1999. 67(4): p. 439-44.
  • Nei, M., et al., EEG and ECG in sudden unexplained death in epilepsy. Epilepsia, 2004. 45(4): p. 338-45.
  • Lathers, C.M. and P.L. Schraeder, Verbal autopsies and SUDEP. Epilepsy Behav, 2009. 14(4): p. 573-6.
  • Schraeder, P.L., et al., Coroner and medical examiner documentation of sudden unexplained deaths in epilepsy. Epilepsy Res, 2006. 68(2): p. 137-43.
  • Terrence, C.F., G.R. Rao, and J.A. Perper, Neurogenic pulmonary edema in unexpected, unexplained death of epileptic patients. Ann Neurol, 1981. 9(5): p. 458-64.
  • Kenneback, G., et al., Changes in arrhythmia profile and heart rate variability during abrupt withdrawal of antiepileptic drugs. Implications for sudden death. Seizure, 1997. 6(5): p. 369-75.
  • Nilsson, L., et al., Antiepileptic drug therapy and its management in sudden unexpected death in epilepsy: a case-control study. Epilepsia, 2001. 42(5): p. 667-73.
  • So, E.L., M.C. Sam, and T.L. Lagerlund, Postictal central apnea as a cause of SUDEP: evidence from near-SUDEP incident. Epilepsia, 2000. 41(11): p. 1494-7.
  • Tellez-Zenteno, J.F., L.H. Ronquillo, and S. Wiebe, Sudden unexpected death in epilepsy: evidence-based analysis of incidence and risk factors. Epilepsy Res, 2005. 65(1-2): p. 101-15.
  • Chin, R.F., B.G. Neville, and R.C. Scott, A systematic review of the epidemiology of status epilepticus. Eur J Neurol, 2004. 11(12): p. 800-10.
  • Wu, Y.W., et al., Incidence and mortality of generalized convulsive status epilepticus in California. Neurology, 2002. 58(7): p. 1070-6.
  • Zielinski, J.J., Epilepsy and mortality rate and cause of death. Epilepsia, 1974. 15(2): p. 191-201.
  • Hauser, W.A., J.F. Annegers, and L.R. Elveback, Mortality in patients with epilepsy. Epilepsia, 1980. 21(4): p. 399-412.
  • Mohanraj, R., et al., Mortality in adults with newly diagnosed and chronic epilepsy: a retrospective comparative study. Lancet Neurol, 2006. 5(6): p. 481-7.
  • Ding, D., et al., Premature mortality in people with epilepsy in rural China: a prospective study. Lancet Neurol, 2006. 5(10): p. 823-7.
  • Shackleton, D.P., et al., Survival of patients with epilepsy: an estimate of the mortality risk. Epilepsia, 2002. 43(4): p. 445-50.
  • Tennis, P., et al., Cohort study of incidence of sudden unexplained death in persons with seizure disorder treated with antiepileptic drugs in Saskatchewan, Canada. Epilepsia, 1995. 36(1): p. 29-36.
There are 26 citations in total.

Details

Primary Language English
Journal Section Original Research
Authors

Rıza Yılmaz This is me

Sinem Akat This is me

Sema Demircin This is me

Bahadır Kumral This is me

Serhat Gurpinar This is me

Erbil Gozukirmizi This is me

Ali Yildirim This is me

Erdal Ozer

Publication Date August 1, 2014
Published in Issue Year 2014 Volume: 4 Issue: 2

Cite

APA Yılmaz, R., Akat, S., Demircin, S., Kumral, B., et al. (2014). Difficulty in diagnosis; epileptic deaths. Çağdaş Tıp Dergisi, 4(2), 59-63.
AMA Yılmaz R, Akat S, Demircin S, Kumral B, Gurpinar S, Gozukirmizi E, Yildirim A, Ozer E. Difficulty in diagnosis; epileptic deaths. J Contemp Med. August 2014;4(2):59-63.
Chicago Yılmaz, Rıza, Sinem Akat, Sema Demircin, Bahadır Kumral, Serhat Gurpinar, Erbil Gozukirmizi, Ali Yildirim, and Erdal Ozer. “Difficulty in Diagnosis; Epileptic Deaths”. Çağdaş Tıp Dergisi 4, no. 2 (August 2014): 59-63.
EndNote Yılmaz R, Akat S, Demircin S, Kumral B, Gurpinar S, Gozukirmizi E, Yildirim A, Ozer E (August 1, 2014) Difficulty in diagnosis; epileptic deaths. Çağdaş Tıp Dergisi 4 2 59–63.
IEEE R. Yılmaz, S. Akat, S. Demircin, B. Kumral, S. Gurpinar, E. Gozukirmizi, A. Yildirim, and E. Ozer, “Difficulty in diagnosis; epileptic deaths”, J Contemp Med, vol. 4, no. 2, pp. 59–63, 2014.
ISNAD Yılmaz, Rıza et al. “Difficulty in Diagnosis; Epileptic Deaths”. Çağdaş Tıp Dergisi 4/2 (August 2014), 59-63.
JAMA Yılmaz R, Akat S, Demircin S, Kumral B, Gurpinar S, Gozukirmizi E, Yildirim A, Ozer E. Difficulty in diagnosis; epileptic deaths. J Contemp Med. 2014;4:59–63.
MLA Yılmaz, Rıza et al. “Difficulty in Diagnosis; Epileptic Deaths”. Çağdaş Tıp Dergisi, vol. 4, no. 2, 2014, pp. 59-63.
Vancouver Yılmaz R, Akat S, Demircin S, Kumral B, Gurpinar S, Gozukirmizi E, Yildirim A, Ozer E. Difficulty in diagnosis; epileptic deaths. J Contemp Med. 2014;4(2):59-63.