Abstract:
Sudden unexpected death in epilepsy (SUDEP) is the commonest cause of death related to epilepsy. There is no
settled proposition among neurologists, neuropathologists and forensic pathologists as to the exact
pathophysiology of SUDEP. Though there is renowned interest about this entity in the developed world, there is
little awareness and interest about SUDEP in the developing world. In the developed countries there are
established SUDEP awareness programmes run by the state and other scientific organizations. They help in
increasing the awareness of this entity among the general public, ensuring safety and well-being of the diagnosed
epileptic patients and updating the knowledge among the clinicians and other academics. It is the authors’ view
that the judicial medical officers in Sri Lanka too owe a similar responsibility and obligation towards the clinicians
and the general public regarding raising the awareness of SUDEP and establishing a clinico-pathologic
correlation. Diagnosis of SUDEP is a challenge in forensic pathology. It needs careful exclusion of suicidal,
homicidal and accidental circumstances as well as other possible natural causes. This warrants careful study of
the scene, history from several sources, meticulous autopsy examination followed by routine and ancillary
investigations. We present a case report of SUDEP highlighting some of the deficiencies in Sri Lanka including
the absence of a protocol to ensure quality-assured minimal standards in the investigation of suspected SUDEP
cases.
