Patients Dying of Sudden Unexplained
Death in Epilepsy to Sudden Death due
to Some Other Cause
Davis GG, McGwin Jr G: Comparison of heart mass in seizure patients dying of
sudden unexplained death in epilepsy to sudden death due to some other cause.
Am J Forensic Med Pathol 2004;25: 23-28.
QUICKIE CHAS REVIEW:
The authors didn't identify or discuss positional asphyxia factors possibly related to the deaths they reviewed. Yet, I am quite pleased that they emphasized the necessity of investigating "scene finding" factors; clearly stating that any "scene finding that accounts for death precludes a diagnosis of SUDEP."
The following excerpts summarize this article:
Abstract: Proposed mechanisms by which sudden unexplained death syndrome in epilepsy (SUDEP) occurs include cardiac dysrhythmias. We hypothesized that individuals dying of SUDEP would have enlarged hearts compared with normal, increasing the risk of sudden cardiac death should the autonomic nervous system initiate a dysrhythmia.
[Introduction:] ... Various mechanisms by which SUDEP may occur have been proposed, including asphyxiation, cardiac arrhythmia precipitated by a seizure discharge acting via the autonomic nervous system, respiratory arrest, and autonomically induced metabolic derangements.
We found no difference in the mean heart mass of individuals dying of SUDEP compared with a control group of individuals with epilepsy who died of some cause other than SUDEP. The diagnosis of SUDEP is a diagnosis of exclusion. Like SIDS, any anatomic, toxicological, or scene finding that accounts for death precludes a diagnosis of SUDEP,...
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