Sudden unexpected death in epilepsy in the bathtub

Hayashi, Kino; Jin, Kazutaka; Nagamori, Chizuko; Okanari, Kazuo; Okanishi, Tohru; Homma, Yoichiro; Iimura, Yasushi; Uda, Takehiro; Takada, Lynne; Otsubo, Hiroshi

doi:10.1016/j.yebeh.2019.04.009

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…It has also been previously reported that most drowning events in patients with epilepsy occur in bathtubs, 23 particularly in Japan where people commonly bathe in bathtubs 24 . Despite the importance of antiepileptic drug management in drowning prevention, there is still a risk of death even when seizures are under control 23,25 . Patients with epilepsy should be fully informed about the risks of bathing, as drowning can take place at home if epileptic seizures occur during bathing.…”

Section: Discussionmentioning

confidence: 99%

“… 24 Despite the importance of antiepileptic drug management in drowning prevention, there is still a risk of death even when seizures are under control. 23 , 25 Patients with epilepsy should be fully informed about the risks of bathing, as drowning can take place at home if epileptic seizures occur during bathing.…”

Section: Discussionmentioning

confidence: 99%

“…under control. 23,25 Patients with epilepsy should be fully informed about the risks of bathing, as drowning can take place at home if epileptic seizures occur during bathing.…”

Section: Type Of Antiseizure Medicationmentioning

confidence: 99%

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Characteristics of deceased subjects transported to a postmortem imaging center due to unusual death related to epilepsy

Ito,

Hata,

Maesawa

et al. 2024

Epilepsia Open

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ObjectivePatients with epilepsy have high risk of experiencing uncommon causes of death. This study aimed to evaluate patients who underwent unusual deaths related to epilepsy and identify factors that may contribute to these deaths and may also include sudden unexpected death in epilepsy (SUDEP).MethodsWe analyzed 5291 cases in which a postmortem imaging (PMI) study was performed using plane CT, because of an unexplained death. A rapid troponin T assay was performed using peripheral blood samples. Clinical information including the cause of death suspected by the attending physician, body position, place of death, medical history, and antiseizure medications was evaluated.ResultsA total of 132 (2.6%) patients had an obvious history of epilepsy, while 5,159 individuals had no history of epilepsy (97.4%). Cerebrovascular disease was the cause of death in 1.6% of patients in the group with epilepsy, and this was significantly lower than that in the non‐epilepsy group. However, drowning was significantly higher (9.1% vs. 4.4%). Unspecified cause of death was significantly more frequent in the epilepsy group (78.0% vs. 57.8%). Furthermore, the proportion of patients who demonstrated elevation of troponin T levels without prior cardiac disease was significantly higher in the epilepsy group (37.9% vs. 31.1%). At discovery of death, prone position was dominant (30.3%), with deaths occurring most commonly in the bedroom (49.2%). No antiseizure medication had been prescribed in 12% of cases, whilst 29.5% of patients were taking multiple antiseizure medications.SignificanceThe prevalence of epilepsy in individuals experiencing unusual death was higher than in the general population. Despite PMI studies, no definitive cause of death was identified in a significant proportion of cases. The high troponin T levels may be explained by long intervals between death and examination or by higher incidence of myocardial damage at the time of death.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Characteristics of deceased subjects transported to a postmortem imaging center due to unusual death related to epilepsy

Ito,

Hata,

Maesawa

et al. 2024

Epilepsia Open

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“…Epileptic diseases are known risk factors for bathtub death [19][20][21][22][23][24][25] . Sudden deaths in epileptic patients do occur, explained by the disease concept sudden unexpected death in epilepsy 26 .…”

Section: Epileptic Diseasementioning

confidence: 99%

Deaths in Bathtubs in Japan: Forensic and Clinical Implications

Kanawaku

2022

J Nippon Med Sch

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In Japan, deaths in bathtubs or bathtub deaths are frequently investigated as unnatural deaths. About 19,000 bathtub deaths occur annually in Japan. This pattern of death has become a social issue in forensic pathology and emergency medicine and public health.It is assumed that the death of an adult by drowning in a bathtub cannot be avoided due to disturbance of consciousness. The PubMed database was used for literature search using the retrieval words, "bathing "OR" bathtub "AND" submersion "OR" drowning "OR" death "OR" cardiopulmonary arrest". From the epidemiological characteristics and pathophysiological findings of bath mortality in Japan, three etiologies of impaired consciousness have been proposed: acute ischemic heart failure, heatstroke, and blood pressure fluctuation. Moreover, other causes such as epilepsy and alcohol or drug intake cannot be ignored as potential risks for death in a bathtub. It is also important to note the possibility of suicide and, although extremely rare, homicide in a bathtub. Despite research, the exact causal relationship between bathtub bathing and death remains unclear.Further, the cause of death by postmortem investigation is not always easily determined.Hence, it is desirable to carry out a field survey of causes of death, including bathing conditions, and, wherever possible, a complete autopsy survey. An exclusion of critical cases such as crime-related death, suicide, drug poisoning, and carbon monoxide poisoning is optimal. Of the many hypotheses about the causes of bathtub mortality, the

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Death in a bathtub of an adolescent with neurofibromatosis type 2 exhibiting meningioangiomatosis with white matter involvement

Sakai,

Hayashi

2024

Forensic Sci Med Pathol

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Sudden unexpected death in epilepsy in the bathtub

Cited by 4 publications

References 22 publications

Characteristics of deceased subjects transported to a postmortem imaging center due to unusual death related to epilepsy

Characteristics of deceased subjects transported to a postmortem imaging center due to unusual death related to epilepsy

Deaths in Bathtubs in Japan: Forensic and Clinical Implications

Death in a bathtub of an adolescent with neurofibromatosis type 2 exhibiting meningioangiomatosis with white matter involvement

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