Case-control study of SUDEP

Langan, Yvonne; Nashef, Lina; Sander, Josemir W.

doi:10.1212/01.wnl.0000156352.61328.cb

Cited by 392 publications

(343 citation statements)

References 27 publications

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“…The National General Practice Study of Epilepsy (NG-PSE), a community-based study in the United Kingdom, saw the first case of SUDEP after 11,000 person-years of follow-up (Lhatoo and Sander 2001), and the results of the Medical Research Council Antiepileptic Drug Withdrawal Study showed that SUDEP is a rare event among patients with epilepsy in remission (1991). Information concerning risk factors for SUDEP is conflicting, but potential risk factors include: early adulthood, early onset of epilepsy (Nilsson et al 1999), long duration of epilepsy (Walczak et al 2001), uncontrolled seizures (mainly in those with TLE) (Walczak et al 2001, Sperling et al 1999, high seizure frequency (Walczak et al 2001, Langan et al 2005, certain seizure types (Walczak et al 2001, Kloster andEngelskjon 1999), higher numbers of AED (Nilsson et al 1999, Walczak et al 2001) and winter temperatures (Scorza et al 2007). Additionally, potential pathomechanisms for SUDEP are unknown, but it is very probable that cardiac arrhythmias during and between seizures, electrolyte disturbances, arrhythmogenic drugs or transmission of epileptic activity to the heart via the autonomic nervous system potentially play a role for SUDEP (Stollberger and Finsterer 2004).…”

Section: General Aspectsmentioning

confidence: 99%

The pilocarpine model of epilepsy: what have we learned?

Scorza

Arida

Naffah-Mazzacoratti

et al. 2009

An. Acad. Bras. Ciênc.

158

103

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The systemic administration of a potent muscarinic agonist pilocarpine in rats promotes sequential behavioral and electrographic changes that can be divided into 3 distinct periods: (a) an acute period that built up progressively into a limbic status epilepticus and that lasts 24 h, (b) a silent period with a progressive normalization of EEG and behavior which varies from 4 to 44 days, and (c) a chronic period with spontaneous recurrent seizures (SRSs). The main features of the SRSs observed during the long-term period resemble those of human complex partial seizures and recurs 2-3 times per week per animal. Therefore, the pilocarpine model of epilepsy is a valuable tool not only to study the pathogenesis of temporal lobe epilepsy in human condition, but also to evaluate potential antiepileptogenic drugs. This review concentrates on data from pilocarpine model of epilepsy.

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Section: General Aspectsmentioning

confidence: 99%

The pilocarpine model of epilepsy: what have we learned?

Scorza

Arida

Naffah-Mazzacoratti

et al. 2009

An. Acad. Bras. Ciênc.

158

103

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“…Seizure alarms and supervision at night are potential interventions to prevent seizure-related hypoxia by repositioning and inducing arousal [29]. Studies indicate that the vast majority of SUDEP cases are unwitnessed [13,14,17], suggesting supervision and early intervention may be helpful in prevention.…”

Section: Preventionmentioning

confidence: 99%

Sudden unexpected death in epilepsy: a silent killer

Seneviratne

2016

Ceylon Med. J.

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“…Due to the small samples with few included SUDEP cases in each study, it has been difficult to assess more than the strongest risk factors, and the precision of the risk estimates has been limited. To counteract these limitations, the ILAE Task Force on Epidemiology pooled data from four major case-control studies [19][20][21][22] of SUDEP that adopted similar SUDEP criteria and all used living epilepsy patients as controls. [23] This pooled analysis included altogether 289 SUDEP cases and 958 living epilepsy controls.…”

Section: Risk Factorsmentioning

confidence: 99%

Sudden Unexpected Death in Epilepsy (SUDEP): an overview

Tomson¹,

Sveinsson²

2013

Epilepsi

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SummarySudden Unexpected Death in Epilepsy (SUDEP) has gained increased awareness over the last 2-3 decades. SUDEP is generally defined as the sudden, unexpected, witnessed or unwitnessed, non-traumatic, and non-drowning death in patients with epilepsy with or without evidence for a seizure, and excluding documented status epilepticus, in which postmortem examination does not reveal a structural or toxicologic cause for death. Sudden death is at least 20 times more common in people with epilepsy compared with the general population. The risk of SUDEP, however, varies widely within the epilepsy population, being the highest in patient with chronic treatment resistent epilepsy. There are probably a number of different mechanisms behind SUDEP, but most research has focused on seizure-related respiratory depression, cardiac arrhythmia, cerebral depression and autonomic dysfunction. Since the frequency of tonic-clonic seizures is the largest risk factor, effective treatment for epilepsy is the best prevention for SUDEP.Key words: Sudden unexpected death in epilepsy; SUDEP; tonic-clonic seizures. ÖzetSon 20-30 yılda epilepside ani beklenmedik ölüm (Sudden Unexpected Death in Epilepsy -SUDEP) artan bir farkındalık kazanmıştır. SUDEP, postmortem incelemenin ölümün yapısal ve toksikolojik nedenini ortaya çıkartamadığı, belgelenmiş status epilepticus dışında kasılma nö-betleri kanıtları olan veya olmayan, genellikle ani, beklenmedik, tanık olunmuş veya olunmamış, travma ve boğulmaya bağlı olmayan ölüm olarak tanımlanmaktadır. Toplum geneline göre epilepsili kişilerde ani ölüm en azından 20 kez daha sık görülmektedir. Ancak SUDEP riski epileptik popülasyonda geniş ölçüde değişmektedir. İnatçı epilepsi için kronik tedavi alanlarda bu risk en yüksek düzeydedir. Olasılıkla SUDEP'in altta yatan birçok farklı mekanizması olmasına rağmen araştırmaların çoğu nöbetlerle ilişkili solunum baskılanması, kalp ritim bozuklukları, serebral depresyon ve anatomik işlev bozukluğuna odaklanmıştır. Tonik-klonik konvülsiyonların sıklığı en buyük risk faktörü olduğu için SUDEP'i önlemenin en iyi yolu epilepsinin etkili tedavisi olmaktadır.

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Case-control study of SUDEP

Abstract: 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.

Cited by 392 publications

References 27 publications

The pilocarpine model of epilepsy: what have we learned?

The pilocarpine model of epilepsy: what have we learned?

Sudden unexpected death in epilepsy: a silent killer

Sudden Unexpected Death in Epilepsy (SUDEP): an overview

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