<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2015-0004_s_001"><h3>Introduction</h3><p>SUDEP is not so rare event, unexplained, underused and underestimated. Its awareness has recently contributed to a number of initiatives for global action and clinical and experimental research.</p></sec><sec id="j_joepi-2015-0004_s_002"><h3>Aim</h3><p>To undertake a literature review so as to update various aspects of SUDEP: pathophysiological mechanisms, potential markers for autonomic dysfunctions and risk factors, AEDs effects, non-AED management options, forensic/autopsy, patient-physician communications in patients with SUDEP risk.</p></sec><sec id="j_joepi-2015-0004_s_003"><h3>Method</h3><p>A literature review, up to Nov. 2012, was conducted using PubMed-Medline for SUDEP, no indexed citation and relevant papers.</p></sec><sec id="j_joepi-2015-0004_s_004"><h3>Review</h3><p>Interactions between the central and peripheral origin of cardiac and respiratory dysfunctions, triggered by epileptiform discharges in the cortical representation of the autonomic functions, may lead to SUDEP during simple partial autonomic seizures - even without other components of a seizure. A number of potential biomarkers of autonomic dysfunctions and risk of SUDEP are identified and proposed to use in its prevention: heart rate variability, long and short QT, arrhythmias, asystole, oxygen desaturation, apneas, hypoxia, postictal EEG suppression, circadian seizure pattern.</p></sec><sec id="j_joepi-2015-0004_s_005"><h3>Conclusions</h3><p>Risk factors for SUDEP, AEDs effects, non-AED management of preventive options and forensic autopsy in diagnosis of SUDEP are discussed. Periictal long term video EEG, ECG and oxygen saturation monitoring may contribute to better understanding of SUDEP mechanisms and eventually to its prevention. SUDEP occurs as fatal coexistence of several predisposing risk factors. Diagnosis of SUDEP is underestimated and underused. In patient with high risk factors for SUDEP, in particular, with AED noncompliance, prognosis of epilepsy should be discussed with patient.</p></sec></abstract>

IntroductionSUDEP is not so rare event, unexplained, underused and underestimated. Its awareness has recently contributed to a number of initiatives for global action and clinical and experimental research.AimTo undertake a literature review so as to update various aspects of SUDEP: pathophysiological mechanisms, potential markers for autonomic dysfunctions and risk factors, AEDs effects, non-AED management options, forensic/autopsy, patient-physician communications in patients with SUDEP risk.MethodA literature review, up to Nov. 2012, was conducted using PubMed-Medline for SUDEP, no indexed citation and relevant papers.ReviewInteractions between the central and peripheral origin of cardiac and respiratory dysfunctions, triggered by epileptiform discharges in the cortical representation of the autonomic functions, may lead to SUDEP during simple partial autonomic seizures - even without other components of a seizure. A number of potential biomarkers of autonomic dysfunctions and risk of SUDEP are identified and proposed to use in its prevention: heart rate variability, long and short QT, arrhythmias, asystole, oxygen desaturation, apneas, hypoxia, postictal EEG suppression, circadian seizure pattern.ConclusionsRisk factors for SUDEP, AEDs effects, non-AED management of preventive options and forensic autopsy in diagnosis of SUDEP are discussed. Periictal long term video EEG, ECG and oxygen saturation monitoring may contribute to better understanding of SUDEP mechanisms and eventually to its prevention. SUDEP occurs as fatal coexistence of several predisposing risk factors. Diagnosis of SUDEP is underestimated and underused. In patient with high risk factors for SUDEP, in particular, with AED noncompliance, prognosis of epilepsy should be discussed with patient.

Sudden Unexpected Death In Epilepsy (SUDEP) – an update

Journal of Epileptology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"Sudden Unexpected Death In Epilepsy (SUDEP) \u2013 an update"}

IntroductionSUDEP is not so rare event, unexplained, underused and underestimated. Its awareness has recently contributed to a number of initiatives for global...

Sudden Unexpected Death In Epilepsy (SUDEP) – an update

Published Online: Feb 22, 2013

Page range: 37 - 54

Received: Jan 04, 2013

Accepted: Feb 19, 2013

DOI: https://doi.org/10.21307/joepi-2015-0004

Keywords
SUDEP, animal seizure models and autonomic dysfunctions, potential biomarkers of SUDEP risk, risk factors of SUDEP, AEDs, autopsy

© 2013 Jerzy Majkowski et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Sudden Unexpected Death In Epilepsy (SUDEP) – an update

Published Online: Feb 22, 2013

Page range: 37 - 54

Received: Jan 04, 2013

Accepted: Feb 19, 2013

DOI: https://doi.org/10.21307/joepi-2015-0004

KeywordsSUDEP, animal seizure models and autonomic dysfunctions, potential biomarkers of SUDEP risk, risk factors of SUDEP, AEDs, autopsy

© 2013 Jerzy Majkowski et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
SUDEP, animal seizure models and autonomic dysfunctions, potential biomarkers of SUDEP risk, risk factors of SUDEP, AEDs, autopsy