Sudden unexpected death in epilepsy
| Sudden unexpected death in epilepsy | |
|---|---|
| Specialty | Neurology |
Sudden unexpected death in epilepsy (SUDEP) refers to the sudden, unexpected death of a person with epilepsy that is not the result of trauma, drowning, or an identified medical condition. In most cases, no structural or toxicological cause of death is found at autopsy. SUDEP can occur with or without evidence of a preceding seizure, and is often unwitnessed, especially during sleep.[1][2][3]
The exact mechanisms underlying SUDEP remain unclear but are believed to be multifactorial.[3] Potential contributors include seizure-related disruptions in breathing, heart rhythm, or brain function, often in combination.[4]
SUDEP is estimated to affect approximately 1 in 1,000 adults and 1 in 4,500 children with epilepsy each year.[5] It accounts for 7% to 17% of epilepsy-related deaths overall, and up to 50% in those with refractory epilepsy.[3][4][6] Deaths caused by status epilepticus or accidents such as drowning are classified separately.[7]
- ^ Nashef, L; So, EL; Ryvlin, P; Tomson, T (Feb 2012). "Unifying the definitions of sudden unexpected death in epilepsy". Epilepsia. 53 (2): 227–33. doi:10.1111/j.1528-1167.2011.03358.x. PMID 22191982. S2CID 19119225.
- ^ Ryvlin, Philippe; Nashef, Lina; Tomson, Torbjörn (2013). "Prevention of sudden unexpected death in epilepsy: A realistic goal?". Epilepsia. 54 (s2): 23–28. doi:10.1111/epi.12180. ISSN 1528-1167. PMID 23646967.
- ^ a b c Terra, VC; Cysneiros, R; Cavalheiro, EA; Scorza, FA (Mar 2013). "Sudden unexpected death in epilepsy: from the lab to the clinic setting". Epilepsy & Behavior. 26 (3): 415–20. doi:10.1016/j.yebeh.2012.12.018. PMID 23402930. S2CID 3777598.
- ^ a b Devinsky, Orrin (10 November 2011). "Sudden, Unexpected Death in Epilepsy". New England Journal of Medicine. 365 (19): 1801–1811. doi:10.1056/NEJMra1010481. PMID 22070477.
- ^ Harden, C; Tomson, T; Gloss, D; Buchhalter, J; Cross, JH; Donner, E; French, JA; Gil-Nagel, A; Hesdorffer, DC; Smithson, WH; Spitz, MC; Walczak, TS; Sander, JW; Ryvlin, P (25 April 2017). "Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society". Neurology. 88 (17): 1674–1680. doi:10.1212/WNL.0000000000003685. PMID 28438841.
- ^ Tolstykh, GP; Cavazos, JE (Mar 2013). "Potential mechanisms of sudden unexpected death in epilepsy". Epilepsy & Behavior. 26 (3): 410–4. doi:10.1016/j.yebeh.2012.09.017. PMID 23305781. S2CID 11221534.
- ^ Tomson T, Nashef L, Ryvlin P (November 2008). "Sudden unexpected death in epilepsy: current knowledge and future directions". Lancet Neurology. 7 (11): 1021–31. doi:10.1016/S1474-4422(08)70202-3. PMID 18805738. S2CID 5087703.