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Difficulty in diagnosis; epileptic deaths

Yıl 2014, Cilt: 4 Sayı: 2, 59 - 63, 01.08.2014

Öz

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.

Kaynakça

  • 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

Yıl 2014, Cilt: 4 Sayı: 2, 59 - 63, 01.08.2014

Öz

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

Kaynakça

  • 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.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Orjinal Çalışma
Yazarlar

Rıza Yılmaz Bu kişi benim

Sinem Akat Bu kişi benim

Sema Demircin Bu kişi benim

Bahadır Kumral Bu kişi benim

Serhat Gurpinar Bu kişi benim

Erbil Gozukirmizi Bu kişi benim

Ali Yildirim Bu kişi benim

Erdal Ozer

Yayımlanma Tarihi 1 Ağustos 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 4 Sayı: 2

Kaynak Göster

APA Yılmaz, R., Akat, S., Demircin, S., Kumral, B., vd. (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. Ağustos 2014;4(2):59-63.
Chicago Yılmaz, Rıza, Sinem Akat, Sema Demircin, Bahadır Kumral, Serhat Gurpinar, Erbil Gozukirmizi, Ali Yildirim, ve Erdal Ozer. “Difficulty in Diagnosis; Epileptic Deaths”. Çağdaş Tıp Dergisi 4, sy. 2 (Ağustos 2014): 59-63.
EndNote Yılmaz R, Akat S, Demircin S, Kumral B, Gurpinar S, Gozukirmizi E, Yildirim A, Ozer E (01 Ağustos 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, ve E. Ozer, “Difficulty in diagnosis; epileptic deaths”, J Contemp Med, c. 4, sy. 2, ss. 59–63, 2014.
ISNAD Yılmaz, Rıza vd. “Difficulty in Diagnosis; Epileptic Deaths”. Çağdaş Tıp Dergisi 4/2 (Ağustos 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 vd. “Difficulty in Diagnosis; Epileptic Deaths”. Çağdaş Tıp Dergisi, c. 4, sy. 2, 2014, ss. 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.