Untreated Absence Seizures Leads to Sudden Death


This case involves a 40-year-old woman that was referred by her primary care physician for absence seizures. This was a reoccurring issue as described by the patient that seemed to last about 30 seconds each time. The patient underwent several imaging studies of her brain that showed the normal appearance of brain structures. The physician gave the patient a  long-term monitor which was followed up by a neurologist who reviewed the EEGs. The doctor found distinct sharp waves and made a diagnosis of temporal lobe epilepsy but did not prescribe any medication at this visit, with a follow-up planned for a month later. The patient was found dead two weeks after the last visit to the neurologist.

Question(s) For Expert Witness

  • 1. What treatments should a patient receive once they are diagnosed with temporal lobe epilepsy?

Expert Witness Response E-005516

In general, once the diagnosis of epilepsy is made, i.e. recurrent unprovoked seizures, treatment should be initiated immediately. Depending on seizure frequency and severity, the chosen agent and aggressiveness of the titration can be quite variable. If it appears that the death was SUDEP, sudden unexpected death in epilepsy, then treatment certainly may have prevented the occurrence.

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