Toluene abuse as a contributing factor in a case of fatal autoerotic asphyxia

• Published in: Legal medicine (Tokyo, Japan) Japan), 2022-07, Vol.57, p.102062-102062, Article 102062
• Main Authors: Handlos, Petr, Gebauerová, Vladimíra, Papoušek, Roman, Handlosová, Klára, Dokoupil, Marek, Klabal, Ondřej, Uvíra, Matěj
• Format: Article
• Language: English
• Subjects: Autoerotic asphyxia; Autoerotic death; Death scene investigation; Intoxication; Toluene; Volatile substances
• ISSN: 1344-6223; 1873-4162
• DOI: 10.1016/j.legalmed.2022.102062

•Autoerotic asphyxia is a form of deviant sexual behavior.•Frequent cause of death in such fatalities is asphyxia during sexual stimulation.•The case of an accidental autoerotic fatality involving victim’s abuse of toluene.•Drug abuse in cases of autoerotic asphyxia may increase the risk of fatal results. Autoerotic asphyxia is a form of deviant sexual behavior that seeks sexual gratification by means of manipulation with one’s own body resulting in asphyxia, and may sometimes turn out to be fatal. Autoerotic fatalities involving autoerotic asphyxia are divided into two groups: “typical” autoerotic fatalities involve mechanical compression of the neck, chest or abdomen, whereas “atypical” autoeroticism involves sexual self-stimulation by other means. Cases where asphyxiophilic behavior is accompanied by volatile substance abuse are reported to be rather rare, but may involve a high risk of fatal results. This paper presents a case of accidental “atypical” autoeroticism involving victim’s abuse of toluene, which, combined with asphyxiophilic airway occlusion, led to death. For the sake of comprehensiveness, both a verbal description and a schematic representation of the major metabolic pathways of acute and chronic abuse metabolic markers is provided.