Terrence C F, Rao G R, Perper J A
Ann Neurol. 1981 May;9(5):458-64. doi: 10.1002/ana.410090508.
Eight cases of unexpected, unexplained death in young ambulatory epileptics were examined postmortem with special attention to the heart and lungs. Lung weights uniformly exceeded the expected value, with gross evidence of hemorrhagic pulmonary edema. Microscopic examination revealed moderate to severe pulmonary edema with protein-rich fluid as well as alveolar hemorrhage. There was no evidence of recent or old myocardial disease. Although death due to a seizure is usually thought to be almost instantaneous, the neurogenic pulmonary edema exemplified by these cases takes time to develop and may be remediable. The high frequency of absent or non-therapeutic anticonvulsant levels at the time of death in these patients may play a role in a possible centrally mediated adrenergic cause of neurogenic pulmonary edema and ventricular arrhythmia.
对8例年轻非卧床癫痫患者意外、不明原因死亡病例进行了尸检，特别关注心脏和肺部。肺重量均超过预期值，有出血性肺水肿的大体证据。显微镜检查显示中度至重度肺水肿，伴有富含蛋白质的液体以及肺泡出血。没有近期或陈旧性心肌疾病的证据。虽然通常认为癫痫发作导致的死亡几乎是瞬间发生的，但这些病例所例证的神经源性肺水肿需要时间发展，且可能是可治疗的。这些患者死亡时抗惊厥药水平缺乏或未达到治疗浓度的高频率情况，可能在神经源性肺水肿和室性心律失常的可能中枢介导的肾上腺素能病因中起作用。
