Unexpected epileptic deaths, statistical trends of Tokyo medical examiner's office

Abstract

Tokyo medical examiner's office conducts postmortem examination and determine cause and manner of death for all cases of sudden and unexpected death and unnatural death within the central part of Tokyo. If the cause of death cannot be determined by the external examination, we perform an autopsy examination. We report the statistical trends of unexpected epileptic deaths for 20 years, from 1995 to 2015. The total number of unexpected epileptic deaths was 364 cases (0.15% of the total inspection number), including 201 cases (55.2%) of autopsy examinations. The acute death which is comparable to SUDEP was ranked first (52.5%, 191/364). Males were two-and-a-half times large number than females (135 males, 56 females) and more than half of the cases occurred while asleep. The second was death by drowning (29.1%, 106/364). The drowning occurred with nearly equal frequency in both sexes (52 males, 54 females). We found that the characteristic body position of epileptic death was "legs up" as if they slid down the back of the bathtub under the water.