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Sudden unexpected death in epilepsy: Investigation of autopsy-based studies

Epilepsy is a common neurological disorder that is associated with increased morbidity and mortality. Sudden unexpected death in epilepsy (SUDEP) is one of the most common causes for epilepsy-related deaths and its characteristics remain largely unknown, particularly from a forensic autopsy perspect...

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Autores principales: Yan, Fengping, Zhang, Fu, Yan, Yanan, Zhang, Le, Chen, Yuanyuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978181/
https://www.ncbi.nlm.nih.gov/pubmed/36873450
http://dx.doi.org/10.3389/fneur.2023.1126652
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author Yan, Fengping
Zhang, Fu
Yan, Yanan
Zhang, Le
Chen, Yuanyuan
author_facet Yan, Fengping
Zhang, Fu
Yan, Yanan
Zhang, Le
Chen, Yuanyuan
author_sort Yan, Fengping
collection PubMed
description Epilepsy is a common neurological disorder that is associated with increased morbidity and mortality. Sudden unexpected death in epilepsy (SUDEP) is one of the most common causes for epilepsy-related deaths and its characteristics remain largely unknown, particularly from a forensic autopsy perspective. The present study aimed to investigate the neurological, cardiac, and pulmonary findings for a total of 388 SUDEP decedents, encompassing three cases from our forensic center during 2011–2020 and 385 literature-reported autopsy cases. In the cases mentioned in this study, two of them presented with only mild cardiac abnormalities, such as focal myocarditis and mild coronary atherosclerosis of the left anterior coronary artery. The third one was negative of any pathological findings. After pooling together these SUDEP cases, we found that neurological changes (n = 218 cases, 56.2%) were the most common postmortem findings associated with SUDEP, with cerebral edema/congestion (n = 60 cases, 15.5%) and old traumatic brain injury (n = 58 cases, 14.9%) being the major findings. Interstitial fibrosis, myocyte disarray/hypertrophy, and mild coronary artery atherosclerosis were the most common findings related to primary cardiac pathology, documented in 49 (12.6%), 18 (4.6%), and 15 (3.9%) cases, respectively. Non-specific pulmonary edema was the major finding in the lungs. This is an autopsy-based study that reports the scenario of postmortem findings for SUDEP cases. Our study paves the way for understanding the pathogenesis of SUDEP and the interpretation of death.
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spelling pubmed-99781812023-03-03 Sudden unexpected death in epilepsy: Investigation of autopsy-based studies Yan, Fengping Zhang, Fu Yan, Yanan Zhang, Le Chen, Yuanyuan Front Neurol Neurology Epilepsy is a common neurological disorder that is associated with increased morbidity and mortality. Sudden unexpected death in epilepsy (SUDEP) is one of the most common causes for epilepsy-related deaths and its characteristics remain largely unknown, particularly from a forensic autopsy perspective. The present study aimed to investigate the neurological, cardiac, and pulmonary findings for a total of 388 SUDEP decedents, encompassing three cases from our forensic center during 2011–2020 and 385 literature-reported autopsy cases. In the cases mentioned in this study, two of them presented with only mild cardiac abnormalities, such as focal myocarditis and mild coronary atherosclerosis of the left anterior coronary artery. The third one was negative of any pathological findings. After pooling together these SUDEP cases, we found that neurological changes (n = 218 cases, 56.2%) were the most common postmortem findings associated with SUDEP, with cerebral edema/congestion (n = 60 cases, 15.5%) and old traumatic brain injury (n = 58 cases, 14.9%) being the major findings. Interstitial fibrosis, myocyte disarray/hypertrophy, and mild coronary artery atherosclerosis were the most common findings related to primary cardiac pathology, documented in 49 (12.6%), 18 (4.6%), and 15 (3.9%) cases, respectively. Non-specific pulmonary edema was the major finding in the lungs. This is an autopsy-based study that reports the scenario of postmortem findings for SUDEP cases. Our study paves the way for understanding the pathogenesis of SUDEP and the interpretation of death. Frontiers Media S.A. 2023-02-16 /pmc/articles/PMC9978181/ /pubmed/36873450 http://dx.doi.org/10.3389/fneur.2023.1126652 Text en Copyright © 2023 Yan, Zhang, Yan, Zhang and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Yan, Fengping
Zhang, Fu
Yan, Yanan
Zhang, Le
Chen, Yuanyuan
Sudden unexpected death in epilepsy: Investigation of autopsy-based studies
title Sudden unexpected death in epilepsy: Investigation of autopsy-based studies
title_full Sudden unexpected death in epilepsy: Investigation of autopsy-based studies
title_fullStr Sudden unexpected death in epilepsy: Investigation of autopsy-based studies
title_full_unstemmed Sudden unexpected death in epilepsy: Investigation of autopsy-based studies
title_short Sudden unexpected death in epilepsy: Investigation of autopsy-based studies
title_sort sudden unexpected death in epilepsy: investigation of autopsy-based studies
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978181/
https://www.ncbi.nlm.nih.gov/pubmed/36873450
http://dx.doi.org/10.3389/fneur.2023.1126652
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