Sudden unexpected death in epilepsy (SUDEP) is a fatal complication of epilepsy.[1] It is defined as the sudden and unexpected, non-traumatic and non-drowning death of a person with epilepsy, without a toxicological or anatomical cause of death detected during the post-mortem examination.[2][3]
While the mechanisms underlying SUDEP are still poorly understood, it is possibly the most common cause of death as a result of complications from epilepsy, accounting for between 7.5 and 17% of all epilepsy-related deaths[2] and 50% of all deaths in refractory epilepsy.[4][5] The causes of SUDEP seem to be multifactorial[2] and include respiratory, cardiac, and cerebral factors as well as the severity of epilepsy and seizures.[5] Proposed pathophysiological mechanisms include seizure-induced cardiac and respiratory arrests.[4]
Among epileptics, SUDEP occurs in about 1 in 1,000 adults and 1 in 4,500 children annually.[6] Rates of death as a result of prolonged seizures (status epilepticus) are not classified as SUDEP.[7]
^Ryvlin, P; Nashef, L; Tomson, T (May 2013). "Prevention of sudden unexpected death in epirealistic goal?". Epilepsia. 54 Suppl 2: 23–8. doi:10.1111/epi.12180. PMID 23646967.
^ abcTerra, 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.
^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.
^ abTolstykh, 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.
^ abDevinsky, 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.
^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.
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