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首页> 外文期刊>Forensic science international >Sudden unexpected death in epilepsy: Evaluation of forensic autopsy cases
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Sudden unexpected death in epilepsy: Evaluation of forensic autopsy cases

机译：癫痫突然死亡：法医尸检案例的评估

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摘要

Epilepsy is a common chronic neurological disorder characterized by seizures. Mortality is significantly increased in patients with epilepsy. Sudden unexpected death in epilepsy (SUDEP) is the most common seizure-related category of death. A retrospective study of forensic autopsy cases from 2007 to 2009 at the Office of the Chief Medical Examiner (OCME) yielded a total of 104 sudden unexpected deaths directly or indirectly caused by an epilepsy/seizure disorder in the State of Maryland. Of these deaths, 74 cases met a general accepted definition of SUDEP. The age of SUDEP individuals ranged from 14 to 63 with the majority of subjects in the ages between 21 and 50 years (58 cases, 78.4%). Males were slightly more likely than females to die of SUDEP (male:female = 1.5:1 based on the rate). The onset age of epilepsy was documented in 47.3% of cases (35/74) based on investigation and medical records. Of the 35 cases, 12 subjects had early onset epilepsy (onset ages 1-15 years) and 20 subjects had duration of epilepsy for more than 10 years. The majority of deaths (61 of the 74 cases, 82.4%) were unwitnessed. Death scene investigation showed that 71 deaths (95.9%) occurred inside their residence with 50 subjects (70.4%) found either in bed or on the bedroom floor near the bed. Forty-three out of 74 cases (58.1%) showed neuropathological lesions. Per history, 50 subjects were reported as being on anti-epileptic drugs (AEDs). However, postmortem toxicological analysis revealed that only 26 subjects (35.1%) had detectable AEDs. Of the 74 cases, seizure disorder or epilepsy was listed as primary cause of death in 66 cases and the term of SUDEP as official cause of death in only 8 cases. This report focuses on the characteristics of death scene investigation and postmortem examination findings of SUDEP cases.
机译：癫痫病是一种以癫痫发作为特征的常见慢性神经系统疾病。癫痫患者的死亡率显着增加。癫痫猝死（SUDEP）是与癫痫发作最常见的死亡类别。首席医学检查官办公室（OCME）对2007年至2009年的法医尸检案例进行了回顾性研究，结果发现共有104例由马里兰州的癫痫/癫痫病直接或间接导致的意外意外死亡。在这些死亡中，有74例符合SUDEP的公认定义。 SUDEP个人的年龄介于14至63岁之间，大多数受试者的年龄介于21至50岁之间（58例，占78.4％）。男性死于SUDEP的可能性略高于女性（根据发病率，男性：女性= 1.5：1）。根据调查和医疗记录，有47.3％的病例（35/74）记录了癫痫的发病年龄。在这35例病例中，有12名受试者患有早发型癫痫病（发病年龄1-15岁），而20名受试者患有癫痫病持续时间超过10年。大多数死亡（74例中的61例，占82.4％）是目击者。死亡现场调查显示，有71人（95.9％）死亡是在他们的住宅内发生的，有50名受试者（70.4％）被发现在床上或床旁的卧室地板上。 74例中有43例（58.1％）表现出神经病理学病变。根据病史，据报道有50名受试者正在服用抗癫痫药（AED）。然而，事后毒理学分析显示，只有26名受试者（35.1％）具有可检测的AED。在这74例病例中，癫痫发作或癫痫病是66例主要死亡原因，而SUDEP术语是官方的死亡原因，只有8例。本报告重点介绍SUDEP病例的死亡现场调查和验尸结果。

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