TY - JOUR
T1 - Severe pulmonary congestion in a near miss at the first seizure
T2 - Further evidence for respiratory dysfunction in sudden unexpected death in epilepsy
AU - Pezzella, Marianna
AU - Striano, Pasquale
AU - Ciampa, Clotilde
AU - Errichiello, Luca
AU - Penza, Pietro
AU - Striano, Salvatore
PY - 2009/4
Y1 - 2009/4
N2 - Sudden unexpected death in epilepsy (SUDEP) is the most important direct seizure-related cause of death, and most cases usually occur in patients with intractable, longstanding epilepsy. Suspected mechanisms for SUDEP include central and obstructive apnea, cardiac arrhythmia, postictal respiratory arrest, and primary cessation of brain activity. We report a patient who experienced a near SUDEP following his first prolonged tonic-clonic seizure requiring intubation. Chest X-ray examination showed severe bilateral congestion of the middle and superior pulmonary fields and an enlarged heart. Observations of pulmonary compromise in near-miss patients are extremely rare. Our patient showed marked cyanosis and respiratory distress after the index seizure, in agreement with the view that respiratory distress was the primary etiology in this case. Moreover, this observation confirms that SUDEP is not exclusively an issue for patients with chronic, uncontrolled epilepsy.
AB - Sudden unexpected death in epilepsy (SUDEP) is the most important direct seizure-related cause of death, and most cases usually occur in patients with intractable, longstanding epilepsy. Suspected mechanisms for SUDEP include central and obstructive apnea, cardiac arrhythmia, postictal respiratory arrest, and primary cessation of brain activity. We report a patient who experienced a near SUDEP following his first prolonged tonic-clonic seizure requiring intubation. Chest X-ray examination showed severe bilateral congestion of the middle and superior pulmonary fields and an enlarged heart. Observations of pulmonary compromise in near-miss patients are extremely rare. Our patient showed marked cyanosis and respiratory distress after the index seizure, in agreement with the view that respiratory distress was the primary etiology in this case. Moreover, this observation confirms that SUDEP is not exclusively an issue for patients with chronic, uncontrolled epilepsy.
KW - First seizure
KW - Near miss
KW - Pulmonary congestion
KW - Sudden unexpected death in epilepsy
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U2 - 10.1016/j.yebeh.2009.02.012
DO - 10.1016/j.yebeh.2009.02.012
M3 - Article
C2 - 19232547
AN - SCOPUS:63749116644
VL - 14
SP - 701
EP - 702
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
SN - 1525-5050
IS - 4
ER -