Finding into death of Roderick James Milner

53y · Male·Refractory seizures secondary to Lennox-Gastaut syndrome (palliated); pneumonia

A 53-year-old man with Lennox-Gastaut syndrome and refractory seizures presented to hospital on 30 March 2024 with increased seizure activity. During admission, he could not receive oral anti-epileptics due to poor swallowing, and there were difficulties administering intravenous anti-epileptics. He was transferred to palliative care and died on 5 April 2024. The cause of death was refractory seizures secondary to Lennox-Gastaut syndrome and pneumonia (likely aspiration). The coroner accepted the forensic pathologist's opinion that this was a natural death. No preventable errors or system failures were identified in the finding. The case highlights the challenging management of refractory seizures in patients with swallowing difficulties and severe neurological disability.