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      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.

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          Abstract

          To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified.

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          Combined analysis of risk factors for SUDEP.

          Dale Hesdorffer, Torbjörn Tomson, Emma Benn … (2011)
          To pool data from four published case-control studies of sudden unexpected death in epilepsy (SUDEP) with live controls, to increase the power to determine risk factors.
          Article 0 comments Cited 60 times – based on 0 reviews     Review now
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            Sudden unexpected death in epilepsy: people with nocturnal seizures may be at highest risk.

            Regis Lamberts, Michael A Laffan, Roland Thijs … (2012)
            Most people with epilepsy who die suddenly and whose death is attributed to sudden unexpected death in epilepsy (SUDEP) are found in or by the bed for unknown reasons. We assessed whether those with sleep-related SUDEP were more likely to have nocturnal seizures, and whether seizure patterns (diurnal vs. nocturnal) differed from people dying suddenly and living controls with epilepsy. Seizure patterns in a cohort of 154 people with epilepsy who died suddenly and after autopsy conformed to the definition of SUDEP and 616 controls living with epilepsy were classified as having "exclusively diurnal" or "nocturnal seizures." Comparisons were made between the groups. SUDEP was classified as sleep-related or non-sleep-related based on eyewitness accounts and the circumstances surrounding death. SUDEP was primarily a sleep-related (58%) and unwitnessed (86%) event. If sleep-related, SUDEP was more likely to be unwitnessed [odds ratio (OR) 4.4, 95% confidence interval (CI) 1.6-12]. Those with sleep-related SUDEP were more likely to have a history of nocturnal seizures than those who had non-sleep-related SUDEP (OR 3.6, 95% CI 1.4-9.4). Those who died were more likely to have a history of nocturnal seizures than living controls (OR 3.9, 95% CI 2.5-6.0). After correction for previously established SUDEP risk factors (Langan et al., 2005), the presence of nocturnal seizures remained significant (OR 2.6, 95% CI 1.3-5.0). Nocturnal seizures seem to be an independent risk factor for SUDEP. These findings underscore the importance of preventive measures, which may include night supervision. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.
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              Case-control study of SUDEP.

              Y Langan, L Nashef, J. W. Sander (2005)
              To examine the influence of various factors on the risk of sudden unexpected death in epilepsy (SUDEP). The authors investigated 154 cases in which a postmortem examination was performed. Each case had four controls with epilepsy from the community, matched for age and geographic location. Backward stepwise conditional logistic regression analysis was performed and odds ratios for risk and protection were determined. The risk of SUDEP was increased with a history of generalized tonic-clonic seizures in the previous 3 months (odds ratio [OR]: 13.8, 95% CI: 6.6 to 29.1). The presence of supervision at night was found to be protective (OR: 0.4, 95% CI: 0.2 to 0.8) when a supervising individual shared the same bedroom or when special precautions such as a listening device were employed (OR: 0.1, 95% CI: 0.0 to 0.3). This work lends support to the view that SUDEP is a seizure-related phenomenon and that control of tonic-clonic seizures is important in its prevention. Nocturnal supervision seems to protect against SUDEP.
              Article 0 comments Cited 36 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Neurology
                Title: Neurology
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Electronic): 1526-632X
                ISSN (Print): 0028-3878
                Publication date (Electronic): Apr 25 2017
                Volume: 88
                Issue: 17
                Affiliations
                [1 ] From the Department of Neurology (C.H.), Mount Sinai Health System, New York, NY; Department of Clinical Neuroscience (T.T.), Karolinska Institutet, Stockholm, Sweden; Department of Neurology (D.G.), CAMC Physicians, Charleston, WV; Departments of Pediatrics and Clinical Neurosciences (J.B.), Alberta Children's Hospital, University of Calgary, Canada; Department of Clinical Neurosciences, Institute of Child Health (J.H.C.), and Institute of Neurology (J.W.S.), University College London; Great Ormond Street Hospital for Children NHS Foundation Trust (J.H.C.), London, UK; Department of Paediatrics (E.D.), Division of Neurology, The Hospital for Sick Children, University of Toronto, Canada; Department of Neurology (J.A.F.), New York University Langone Comprehensive Epilepsy Center, New York; Department of Neurology (A.G.-N.), Hospital Ruber Internacional, Madrid, Spain; Gertrude H. Sergievsky Center and Department of Epidemiology (D.C.H.), Columbia University Medical Center, New York, NY; Department of General Practice (W.H.S.), University College Cork, Ireland; Anschutz Outpatient Pavilion (M.C.S.), University of Colorado Health, Aurora; Neurology Clinic (T.S.W.), University of Minnesota, Minneapolis; Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, the Netherlands; and the Department of Clinical Neurosciences (P.R.), CHUV, Lausanne, Switzerland.
                Article
                Publisher Item ID: WNL.0000000000003685
                DOI: 10.1212/WNL.0000000000003685
                PubMed ID: 28438841
                SO-VID: 77292e94-be21-4c1a-a88f-4f365f4d2229
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