Unexpected death in persons with symptomatic epilepsy due to glial brain tumors: a report of two cases and review of the literature

Two cases of unexpected death in persons with epileptic seizures due to a b rain tumor are presented which encompassed an astrocytoma WHO grade II and an anaplastic astrocytoma WHO grade III. A 35-year-old man was found somnol ent and disoriented at home. A computed tomography (CT) scan revealed a tum or of the right frontal lobe suggestive for an oligodendroglioma. During an angiographic examination the patient experienced an epileptic seizure. Som e weeks later, the man was found dead in front of his house with a fresh bi te mark of the tongue. Neuropathological examination revealed an astrocytom a WHO grade II of the right frontal lobe. A 47-year-old man plunged into a swimming-pool and was found submerged some minutes later. After resuscitati on he survived comatous for 8 days but finally died due to severe hypoxic b rain damage. He had been operated on a brain tumor of the temporal lobe 1 y ear before the accident. Neuropathological examination revealed residual tu mor tissue at the operation site corresponding to an anaplastic astrocytoma WHO grade III. Although rare, death in persons with epileptic seizures due to brain tumors is an important mechanism of death encountered by the fore nsic pathologist. (C) 1999 Elsevier Science Ireland Ltd. All rights reserve d.