MEDICOLEGAL AND ETHICAL ASPECTS OF A DEATH CASE DUE TO EPILEPSY: CLINICAL CASE, CLINICAL FORENSICS, OR FORENSIC PATHOLOGY?

Adji Suwandono (Department of Forensics and Medicolegal, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia Sebelas Maret University Hospital, Sukoharjo, Indonesia)
Hedva Rayna Hitipeuw (Medical Profession, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia)
Funica Asri Rachmawaty (Medical Profession, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia)
Sandy Adi Nugraha Pratama (Medical Profession, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia)
Alfonsus Aryo Sunu Bakti (Medical Profession, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia)

Jurnal Kedokteran Diponegoro
Vol 15, No 1 (2026): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)

Background: An unwitnessed death in a man with epilepsy, found in a bathroom with a head injury and immersion, raises key clinical and forensic concerns. This case highlights the complex intersection between epilepsy-related death, head trauma, and possible drowning. Case Presentation: A 39-year-old man with a history of epilepsy was found unconscious in the bathtub, face down with his head submerged and a bleeding forehead wound, approximately 10 minutes after showering. The man had a history of monthly generalized tonic-clonic seizures with recurrent falls and head injuries, and was on regular antiepileptic medicine. On admission, he was unresponsive with a GCS of E1V1M1, absent vital signs, dilated pupils, decreased skin temperature, and a laceration wound on the forehead. An ECG showed asystole. Conclusion: This case reviews the high risk of sudden death in patients with epilepsy, likely involving seizure-induced trauma and possible drowning. It emphasizes the need for comprehensive epilepsy management and thorough medicolegal evaluation to determine the cause of death.