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Medicina Legal de Costa Rica

On-line version ISSN 2215-5287Print version ISSN 1409-0015


CASTRO VARGAS, Luis Fernando. Suden unexpected death in epilepsy. Med. leg. Costa Rica [online]. 2012, vol.29, n.1, pp.43-52. ISSN 2215-5287.

The SUDEP refers to the sudden and unexpected death with or without witnesses, non-traumatic, and not drowning in an epileptic patient, with or without evidence that he suffered a seizure at death, in which a state is ruled seizure as the cause of death in the autopsy did not provide evidence of a toxic or anatomic cause of death. Although SUDEP has been recognized since the nineteenth century, only in the last two decades has been given the importance it requires. SUDEP frequency depends on the severity of epilepsy but in general the risk of sudden death is 20 times higher than the general population. Neurogenic pulmonary edema, central apnea and cardiac arrhythmias induced by α-adrenergic shock of central origin, pathophysiologic mechanisms are the three most closely related to SUDEP. This forces the clinician to perform a thorough autopsy, which should include neuropathological examination to document brain changes that underlie epilepsy, toxicology and examination of the heart, lungs and other organs

Keywords : Sudden unexpected death in epilepsy (SUDEP); generalized tonic-clonic (GTC); neurogenic pulmonary edema (EPN); cardiac arrhythmias; apnea.

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