Drowning in people with epilepsy

Abstract

syndromes, has recently been reported in a family with atypical Panyiotopoulos syndrome (Grosso S et al. Neurology 2007;69:609-611). GOURMAND SYNDROME IN A CHILD WITH EPILEPSY A preoccupation with food, increased appetite and a preference for fine food had developed in a 10-year-old obese boy soon after the onset of refractory seizures at 8 years of age, in a report from University Hospital of Geneva, Switzerland. He had streptococcal B sepsis and hemorrhage in the right temporoparietal lobes during the neonatal period. Seizures were stereotyped, with loss of contact and oral automatisms or dystonic posturing of the left hand. Their frequency was once a week to 7 times a day. They were uncontrolled despite trial of 5 different antiepileptic drugs. He preferred to cook meals for himself rather than eat at fast food restaurants. He had no history of emotional disorder, binge eating, bulimia, or preoccupation with his weight. Neurological examination revealed a left inferior quadrantanopia and left dysdiadochokinesia. In presurgical evaluation, the EEG showed a right posterior focus, and diffuse bilateral parasaggital seizure activity in sleep. MRI revealed a porencephaly, periventricular gliosis and hemosiderin deposits in the right parietal lobe. Neuropsychological examination showed visuospatial memory deficits, discrete signs of neglect, more pronounced in the postictal phase, with perseveration and confabulation.Gourmand" syndrome" reported in adults with right hemisphere lesions is often associated with epilepsy, and the eating disorder may be reversible when epilepsy is controlled. (Levine R et al. Epilepsy Behav 2003;4:781-3; cited by Kurian et al). The authors recommend brain imaging to rule out right hemisphere lesion in a patient who develops disturbed eating habits following a head injury or seizures. RISK OF DROWNING IN EPILEPSY The risk of drowning in patients with epilepsy is quantified by a meta-analysis of published reports, in a study at the Institute of Neurology, Queen Square, London UK. The number of deaths from drowning and the number of person-years at risk were estimated in 51 cohorts of people with epilepsy. Standardized mortality ratios (SMRs) (observed deaths divided by the expected deaths) were calculated for each cohort and for the total population. Compared with 4.7 expected deaths, 88 drowning deaths were reported in people with epilepsy, giving an SMR of 18.7 (95% CI 15-23). The 51 cohorts combined had 206,596 patient-years of follow-up. In people with epilepsy and learning disability, the SMR was 25.7, and in those in institutional care, 96.9. In those with temporal lobectomy for epilepsy, the SMR was 41.1. Using National Registries for estimation of drowning deaths in people

Epilepsy: A Spectrum Disorder

“…Accident-related deaths in people with epilepsy comprised 1.2% -6.5% of all deaths in community-based studies (Sillanpää et al 1998;Lhatoo et al 2001); 7.3% -42% in selected population studies with standard mortality ratios ranging from 2.4% to 5.6% (Institute of Medicine 2012). People with epilepsy have an increased risk of drowning with a standardized mortality ratio of 5.4 to 96.9, which varies depending on the study population (Nilsson et al 1997;Bell et al 2008).…”

“…Reports have noted decreased standardized mortality ratio for malignant neoplasia of the lungs, pancreas, hepatobiliary system, breasts, and lymphoid tissue (DeLorenzo et al 1996). Cancer accounts for 16% -29% of deaths reported with standardized mortality ratios ranging from 3.4% to 5.4% (Lindsten et al 2000;Shackleton et al 2002;Bell et al 2008).…”

Update on drowning

“…In particular, seizure disorders and prolonged QT syndrome must be sought in children considered at risk. [6,7] A concerted effort must be made to educate children and teenagers on survival swimming (flotation), which should be integrated into life skills programmes at school. [8] Personal flotation devices should be encouraged, irrespective of swimming ability, especially in young children.…”

Epilepsy and Sport

“…[21,22] Bu konuda yapılan araştırmalarda özellikle de boğulma ile ilgili artmış bir risk gösterilmiştir. [23][24][25][26][27][28] Yüzülen yer açısından ise boğulma ve ölüm riskinin göl ve nehirlerde yüksek, buna karşın özel havuzda ve cankurtaran mevcudiyetinde düşük olduğu dikkat çekmektedir. [24] Epilepsili kişiler de normal bir hayat yaşama hakkına sahiptir ve kendi seçtikleri bir sporu yapmaya teşvik edilmelidir.…”