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Sudden unexpected death in epilepsy

Author
Steven C Schachter, MD
Section Editor
Timothy A Pedley, MD
Deputy Editor
April F Eichler, MD, MPH

INTRODUCTION

Patients with epilepsy have a small risk of sudden unexpected death, a condition referred to as sudden unexpected death in epilepsy (SUDEP) [1,2]. SUDEP is defined specifically as the sudden, unexpected, witnessed or unwitnessed, nontraumatic and nondrowning death in patients with epilepsy with or without evidence for a seizure, and excluding documented status epilepticus, in which post mortem examination does not reveal a structural or toxicologic cause for death [3].

The cause of SUDEP is uncertain. Observations in individual cases have suggested possible cardiogenic, pulmonary, and primary neurologic etiologies. It may be that SUDEP is a heterogeneous condition. The vast majority of witnessed cases have been associated with a seizure, and the main risk factor is uncontrolled seizures, especially convulsions.

This topic discusses risk factors, causes, and prevention strategies for SUDEP. The management and other complications of seizures and epilepsy are discussed separately. (See "Overview of the management of epilepsy in adults" and "Evaluation and management of drug-resistant epilepsy".)

DEFINITION

Sudden unexpected death in epilepsy (SUDEP) is defined specifically as the sudden, unexpected, witnessed or unwitnessed, nontraumatic and nondrowning death in patients with epilepsy with or without evidence for a seizure, and excluding documented status epilepticus, in which post mortem examination does not reveal a structural or toxicologic cause for death [3,4].

INCIDENCE

SUDEP causes between 2 and 18 percent of all deaths in patients with epilepsy [5-9]. This proportion may be somewhat higher in children, as high as 30 percent in one cohort study [10].

           

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Literature review current through: Nov 2016. | This topic last updated: Tue Nov 01 00:00:00 GMT+00:00 2016.
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