National Association of Medical Examiners Position Paper: Recommendations for the Investigation and Certification of Deaths in People with Epilepsy
- PMID: 31240030
- PMCID: PMC6474453
- DOI: 10.23907/2018.009
National Association of Medical Examiners Position Paper: Recommendations for the Investigation and Certification of Deaths in People with Epilepsy
Abstract
Sudden unexpected death of an individual with epilepsy (SUDEP) can pose a challenge to death investigators, as most deaths are unwitnessed and the individual is commonly found dead in bed. Anatomic findings (e.g., tongue/lip bite) are commonly absent and of varying specificity, limiting the evidence to implicate epilepsy as a cause of or contributor to death. Thus, it is likely that death certificates significantly underrepresent the true number of deaths in which epilepsy was a factor. To address this, members of the National Association of Medical Examiners, North American SUDEP Registry, Epilepsy Foundation SUDEP Institute, American Epilepsy Society, and the Centers for Disease Control and Prevention convened an expert panel to generate evidence-based recommendations for the practice of death investigation and autopsy, toxicological analysis, interpretation of autopsy and toxicology findings, and death certification to improve the precision of death certificate data available for public health surveillance of epilepsy-related deaths. The recommendations provided in this paper are intended to assist medical examiners, coroners, and death investigators when a sudden, unexpected death in a person with epilepsy is encountered.
Keywords: Epilepsy; Forensic pathology; SUDEP; Sudden unexpected death in epilepsy.
Conflict of interest statement
DISCLOSURES & DECLARATION OF CONFLICTS OF INTEREST The opinions and conclusions of this paper have been reviewed and approved by the NAME Board of Directors and as such are endorsed by the National Association of Medical Examiners. These opinions and positions are based on a consensus of the current literature, knowledge, and prevailing theories on this topic. As scientific knowledge and experience grow and change, the National Association of Medical Examiners reserves the right to revise or update these opinions. The process by which NAME position papers are initiated, written, reviewed, and approved is publically available on the NAME website (www.thename.org). All scientific position papers endorsed by the National Association of Medical Examiners automatically expire five years after publication unless reaffirmed, revised, or retired at or before that time. This work is a product of NAME and as such, was not subjected to Academic Forensic Pathology editorial review. The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors, reviewers, editors, and publication staff do not report any relevant conflicts of interest This paper has been simultaneously published in Epilepsia, Volume 59, #3 and Academic Forensic Pathology: The Official Publication of the National Association of Medical Examiners, Volume 8, #1
