Severe postictal laryngospasm as a potential mechanism for sudden unexpected death in epilepsy: a near-miss in an EMU.
A 42-year-old man with refractory epilepsy experienced a 1-min generalized tonic-clonic seizure followed by persistent inspiratory stridor and cyanosis while being monitored in our epilepsy monitoring unit (EMU). Although his cardiac parameters remained stable throughout the event, the patient's respiratory status rapidly declined, despite the urgent administration of oxygen via bag-valve-mask. He was subsequently intubated by the emergency code team, who noted severe laryngospasm while trying to insert the endotracheal tube. The patient was successfully resuscitated. This monitored case demonstrates that postictal laryngospasm may represent another potential cause of sudden unexpected death in epilepsy (SUDEP).
Tavee
Jinny
J
Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. taveej2@ccf.org
Morris
Harold
H
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D003645:Death, Sudden / Q000209:etiology*; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007826:Laryngismus / Q000150:complications* / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D010672:Phenytoin / Q000627:therapeutic use; D012120:Respiration Disorders / Q000209:etiology
D000927:Anticonvulsants; D010672:Phenytoin