On Mysterious Sudden Death in Epileptics : A Case Report and Review of the Literature

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  • YOSHINO Yoshikazu
    Department of Internal Medicine, Kyorin University School of Medicine
  • FUKAI Kohji
    Department of Pathology, Kyorin University School of Medicine
  • AKAI Keiichiro
    Department of Pathology, Kyorin University School of Medicine

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Other Title
  • 癲癇患者の不可解な急死について : 症例報告と文献的考察
  • 癩癇患者の不可解な急死について 症例報告と文献的考察
  • ライカンカンジャ ノ フカカイ ナ キュウシ ニ ツイテ ショウレイ ホウコク ト ブンケンテキ コウサツ

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As is generally known, sudden death of epileptics results from status epilepticus, supervening accidents or concomitant natural diseases. There are, however, unexpected epilepsy fatalities, for which no satisfactory explanations are found clinically as well as pathologically. Our case, 33-year-old female, had epileptic convulsions for about 7 years, with the frequency of 2 to 3 times a year. Her last seizure, which was witnessed by her husband, was rather milder than the previous ones. Moreover, complete gross and microscopic autopsy revealed no lethal anatomic lesion. As possible causes of this incident, severe autonomic nervous dysfunction, or acute disruptions of cardiac or respiratory functions in brain stem or both are suspected in the similar cases reported in the literature. It was suggested that various non-lethal abnormalities or changes might be involved in prompting the usual seizures to lethal. Although this facet of epilepsy mortality has received scant clinical attention, further investigation of factors related or concomitant to seisure will hopefully clarify the mechanism (s) of such a mysterious death.

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