An “amazing” brother and son died after stabbing himself in the chest during an epileptic seizure, an inquest heard.

An inquest into the death of Rayan Essam Mahmoud Bastawi which took place today in Brighton heard that Rayan, 33, had been diagnosed with the condition in his early 20s but his fits had got significantly worse in February 2023.

On February 27, Rayan suffered a severe seizure where he was violent towards himself.

His family told Brighton Coroner’s Court he was “jumping and dancing about” and that they had never seen him have this type of seizure before.

His previous frequent seizures were described as more “focal” than physical, and he could “snap out” of them.

“We couldn’t control him,” they said.

“The seizures were more physical, more violent and longer.

“He convulsed for too long.”

Rayan, of Chiddingly Close in Brighton, was admitted to the Royal Sussex County Hospital in Brighton.

While he was in hospital, he suffered two more seizures and medical staff wanted to keep him in hospital until he had 24 hours without a seizure.

The court heard Rayan had initially agreed to this but soon wished to discharge himself because he felt the hospital environment could be a “trigger” for his seizures.

Medical staff again advised him to stay in the hospital but because he was deemed to have full mental capacity to make his own decision and was aware of the risks of that decision, he was able to discharge himself on March 1.

He was told any discharge was against medical advice and he was told to come back to hospital if he had another seizure.

During the inquest, Rayan’s family said they had wished he had been kept at the hospital and questioned consultant neurologist Dr John Young, who treated Rayan during his time at the Royal Sussex, asking why he was not made to stay.

“If they have mental capacity, we cannot force them to stay,” said Dr Young.

“It would not be legal to retain someone in hospital against their will if they had the mental capacity.”

The court heard Rayan was settled at one of his sisters’ homes in Brighton after his discharge and there were no issues that night.

However, on March 2, Rayan suffered a seizure in the morning before a “more violent episode” in the afternoon.

His family said the 33-year-old fell to the floor shaking uncontrollably and there were attempts to calm him down, but the seizure was “too aggressive” to hold him.

They said Rayan was in no way aware of what he was doing due to the seizure.

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It was not until paramedics arrived shortly after a 999 call that they realised Rayan had a wound to his chest, as well as a head wound.

Paramedics performed CPR but the court heard "Rayan was beyond any help" and he was pronounced dead at the scene.

Detective sergeant Toby Martin of Sussex Police said Rayan had also run into the door as there was a “significant amount of blood on the door from the head injury”.

He was satisfied that there was no criminality involved in Rayan’s death.

A postmortem confirmed Rayan’s medical cause of death was a stab wound to the chest.

Dr Young, when asked by coroner Karen Henderson about Rayan’s probable awareness during the seizure, said: “Broadly speaking under a seizure a person is not aware of what they are doing.”

Dr Young also agreed with Ms Henderson when asked if it would be accurate to say the events of March 2 could not have been foreseen.

The court heard Rayan’s life was “very limited” due to his seizures, but he was “proactive” about his health and had undergone investigative tests at the National Hospital for Neurology and Neurosurgery in Queen Square, London.

He had many scans, but no specific underlying problems were found.

It was agreed that controlling the seizures medically would be more appropriate rather than attempting surgical options.

Rayan was on three types of anti-seizure medication, one of which was increased during his admission to the Royal Sussex at the end of February.

Ms Henderson paid tribute to Rayan’s mother, sisters and brothers for their “strong and loving” support of Rayan and for being his advocate throughout his life.

She returned a narrative conclusion, describing how Rayan’s seizures had worsened, how he had been admitted to hospital and discharged himself and that “in the midst of that seizure, he fatally stabbed himself, piercing his heart and leading to his death”.

Ms Henderson said she was satisfied Rayan was of a mental capacity to discharge himself from hospital in March.

“Medical staff had no ability, no right to keep him in hospital,” she said.

“It was entirely right for him to make that decision.”

Ms Henderson said she was satisfied that “in the seizure Rayan would not have known what he was doing and that his death was “almost instantaneous”.

“He would not have suffered,” she said.

Ms Henderson also said Rayan’s death could not have been foreseen or prevented and praised his family’s strength in attending the hearing.

“This is an absolutely tragic case,” she said.

“It is quite clear that Rayan was a greatly loved member of your family and his loss will resonate for the rest of your lives.

“You have done everything in your power to keep Rayan safe.”

Rayan’s family said Rayan was an amazing and kind man.