Autoerotic death--characteristic features and diagnostic difficulties

Autoerotic death refers to the accidental death of individuals of either sex due to failure of devices, or unexpected effect of materials, that were being used to enhance the sexual experience. Although asphyxia from hanging has been described most frequently, a wide variety of other lethal situations have been reported. As there is great variability in the number and types of sexual aids that may be used by individuals, careful death scene examination is essential in helping to exclude suicide and more rarely homicide. The clandestine nature of this paraphilia may, however, make subsequent identification and diagnosis difficult unless the death scene features are typical. This is particularly so in the rare cases involving women. In the following paper the typical features of this disorder are reviewed with a description of less obvious cases and possible diagnostic pitfalls.