Suicide in two patients with epilepsy and cystic degeneration areas of their brains

Suicide is an important cause of death among patients with epilepsy. In this report, we describe two patients with epilepsy whose brain examinations revealed cystic degeneration areas. The first case was a 42-year-old man who had been treated for epilepsy for five years. It was reported that his epilepsy attacks had increased over the six months prior to his suicide, and that he had severe conflicts with his wife during the last two months. He committed suicide by hanging. An autopsy revealed two cystic degeneration areas on the left temporal lobe, and one cystic degeneration area on the right parietal lobe. The second case was a 30-year-old man who had been receiving epilepsy treatment for 10 years. It was reported that his epilepsy attacks had increased in the four months prior to his suicide, and his wife had left home because of continuous arguments. He committed suicide by drinking rodenticide (aluminum phosphide). An autopsy revealed a cystic degeneration area on the right temporal lobe. Neither of the two cases had a history of head injury, and the cystic areas are evaluated as border zone infarcts due to prolonged hypoxemia caused by recurrent status epilepticus attacks. In conclusion, in case of the determination of the cystic degeneration areas in patients with epilepsy in computed tomography or magnetic resonance imaging examinations, it will be beneficial to follow these patients in terms of epileptic attacks and psychiatric defects. © 2013 Romanian Society of Legal Medicine.