Thanatology: sudden unexpected death in epilepsy: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Thanatology: sudden unexpected death in epilepsy

Sample item

A 24-year-old man with epilepsy is found dead, lying prone in bed with a bitten tongue. Autopsy shows no cause: the brain and heart are unremarkable and drug levels of his anticonvulsant are low. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Sudden unexpected death in epilepsy

In sudden unexpected death in epilepsy the person is usually found dead in bed, often prone, and autopsy shows no anatomical or toxicological cause. A recent seizure may be suggested by a bitten tongue. Poor control and low drug levels are known risk factors.

Option by option

  • A. Death from overdose of the anticonvulsant

    Overdose would show high drug levels, whereas the levels here are low.

  • B. Cerebral oedema from status epilepticus

    Cerebral oedema from status epilepticus would be seen in the brain at autopsy.

  • C. Sudden unexpected death in epilepsy (correct)

    Correct. An unexplained death in a person with epilepsy and no autopsy cause fits this entity.

  • D. Aspiration pneumonia

    Aspiration pneumonia would show consolidated lung at autopsy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is C, Sudden unexpected death in epilepsy. In sudden unexpected death in epilepsy the person is usually found dead in bed, often prone, and autopsy shows no anatomical or toxicological cause.

Why is "Death from overdose of the anticonvulsant" not the answer?

Overdose would show high drug levels, whereas the levels here are low.

Why is "Cerebral oedema from status epilepticus" not the answer?

Cerebral oedema from status epilepticus would be seen in the brain at autopsy.

Why is "Aspiration pneumonia" not the answer?

Aspiration pneumonia would show consolidated lung at autopsy.

What concept does this question test?

It tests Thanatology: sudden unexpected death in epilepsy in Forensic Medicine. A recent seizure may be suggested by a bitten tongue. Poor control and low drug levels are known risk factors.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Thanatology: sudden unexpected death in epilepsy?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.