Sudden Unexpected Death in Epilepsy
Epilepsy is a complex neurological condition with numerous etiologies and treatment options. In a subset of these patients, sudden unexpected death can occur, and to date, there are numerous explanations as to the pathophysiological mechanisms and how to mitigate these catastrophic outcomes. Approxi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Neurology International |
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| Online Access: | https://www.mdpi.com/2035-8377/14/3/48 |
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| author | Teri B. O’Neal Sanjay Shrestha Harsimar Singh Ihianle Osagie Kenechukwu Ben-Okafor Elyse M. Cornett Alan D. Kaye |
| author_facet | Teri B. O’Neal Sanjay Shrestha Harsimar Singh Ihianle Osagie Kenechukwu Ben-Okafor Elyse M. Cornett Alan D. Kaye |
| author_sort | Teri B. O’Neal |
| collection | DOAJ |
| description | Epilepsy is a complex neurological condition with numerous etiologies and treatment options. In a subset of these patients, sudden unexpected death can occur, and to date, there are numerous explanations as to the pathophysiological mechanisms and how to mitigate these catastrophic outcomes. Approximately 2.3 million Americans have epilepsy, and nearly 150,000 people develop the condition each year. Sudden unexpected death in epilepsy (SUDEP) accounts for 2–18% of all epilepsy-related deaths and this is equivalent to one death in 1000 person-years of diagnosed epilepsy. It is more common in young adults aged 20–45. Seizures in the past year; the absence of terminal remission in the last five years; increased seizure frequency, particularly GTCS; and nocturnal seizures are the most potent modifiable risk factors for SUDEP. Patients not receiving any antiepileptic drug therapy are at higher risk of SUDEP. Patient education on medication compliance; care plans for seizure clusters (rescue medicines); epilepsy self-management programs; and lifestyle changes to avoid seizure-triggering factors, including avoiding excessive alcohol use and sleep deprivation, should be provided by health care providers. Continued research into SUDEP will hopefully lead to effective interventions to minimize occurrences. At present, aggressive control of epilepsy and enhanced education for individuals and the public are the most effective weapons for combating SUDEP. This narrative review focuses on updated information related to SUDEP epidemiology; pathophysiology; risk factor treatment options; and finally, a discussion of important clinical studies. We seek to encourage clinicians who care for patients with epilepsy to be aggressive in controlling seizure activity and diligent in their review of risk factors and education of patients and their families about SUDEP. |
| first_indexed | 2024-03-09T22:56:58Z |
| format | Article |
| id | doaj.art-44c7ecd7717345bd9f13c6509c3a8776 |
| institution | Directory Open Access Journal |
| issn | 2035-8377 |
| language | English |
| last_indexed | 2024-03-09T22:56:58Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Neurology International |
| spelling | doaj.art-44c7ecd7717345bd9f13c6509c3a87762023-11-23T18:08:27ZengMDPI AGNeurology International2035-83772022-07-0114360061310.3390/neurolint14030048Sudden Unexpected Death in EpilepsyTeri B. O’Neal0Sanjay Shrestha1Harsimar Singh2Ihianle Osagie3Kenechukwu Ben-Okafor4Elyse M. Cornett5Alan D. Kaye6Department of Family Medicine, LSU Health Shreveport/Monroe Medical Center, Monroe, LA 71202, USADepartment of Family Medicine, LSU Health Shreveport/Monroe Medical Center, Monroe, LA 71202, USADepartment of Family Medicine, LSU Health Shreveport/Monroe Medical Center, Monroe, LA 71202, USADepartment of Family Medicine, LSU Health Shreveport/Monroe Medical Center, Monroe, LA 71202, USADepartment of Family Medicine, LSU Health Shreveport/Monroe Medical Center, Monroe, LA 71202, USADepartment of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA 71103, USADepartment of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA 71103, USAEpilepsy is a complex neurological condition with numerous etiologies and treatment options. In a subset of these patients, sudden unexpected death can occur, and to date, there are numerous explanations as to the pathophysiological mechanisms and how to mitigate these catastrophic outcomes. Approximately 2.3 million Americans have epilepsy, and nearly 150,000 people develop the condition each year. Sudden unexpected death in epilepsy (SUDEP) accounts for 2–18% of all epilepsy-related deaths and this is equivalent to one death in 1000 person-years of diagnosed epilepsy. It is more common in young adults aged 20–45. Seizures in the past year; the absence of terminal remission in the last five years; increased seizure frequency, particularly GTCS; and nocturnal seizures are the most potent modifiable risk factors for SUDEP. Patients not receiving any antiepileptic drug therapy are at higher risk of SUDEP. Patient education on medication compliance; care plans for seizure clusters (rescue medicines); epilepsy self-management programs; and lifestyle changes to avoid seizure-triggering factors, including avoiding excessive alcohol use and sleep deprivation, should be provided by health care providers. Continued research into SUDEP will hopefully lead to effective interventions to minimize occurrences. At present, aggressive control of epilepsy and enhanced education for individuals and the public are the most effective weapons for combating SUDEP. This narrative review focuses on updated information related to SUDEP epidemiology; pathophysiology; risk factor treatment options; and finally, a discussion of important clinical studies. We seek to encourage clinicians who care for patients with epilepsy to be aggressive in controlling seizure activity and diligent in their review of risk factors and education of patients and their families about SUDEP.https://www.mdpi.com/2035-8377/14/3/48epilepsysudden deathcardiac arrestarrythmiaTakotsubo cardiomyopathycounseling |
| spellingShingle | Teri B. O’Neal Sanjay Shrestha Harsimar Singh Ihianle Osagie Kenechukwu Ben-Okafor Elyse M. Cornett Alan D. Kaye Sudden Unexpected Death in Epilepsy Neurology International epilepsy sudden death cardiac arrest arrythmia Takotsubo cardiomyopathy counseling |
| title | Sudden Unexpected Death in Epilepsy |
| title_full | Sudden Unexpected Death in Epilepsy |
| title_fullStr | Sudden Unexpected Death in Epilepsy |
| title_full_unstemmed | Sudden Unexpected Death in Epilepsy |
| title_short | Sudden Unexpected Death in Epilepsy |
| title_sort | sudden unexpected death in epilepsy |
| topic | epilepsy sudden death cardiac arrest arrythmia Takotsubo cardiomyopathy counseling |
| url | https://www.mdpi.com/2035-8377/14/3/48 |
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