Epilepsy and sudden death: Personal reflections and call for global action

Lathers, Claire M.

doi:10.1016/j.yebeh.2009.04.023

Cited by 16 publications

(8 citation statements)

References 102 publications

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“…Therefore, compliance is a key contributor to suboptimal management. [8] The terms compliance and adherence will be used synonymously in this study.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

Molugulu¹,

Gubbiyappa²,

Murthy³

et al. 2016

J Basic Clin Pharma

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Introduction:Reports on medication adherence and its associated factors in patients with epilepsy in South East Asian countries are lacking. The primary purpose of this study was to assess the degree of medication adherence and its relationship with patient's satisfaction, psychosocial factors, quality of life and mental health in a sample of Malaysian epilepsy patients.Methodology:It is a cross-sectional study and was carried out in the outpatient Neurology Department of Hospital Kuala Lumpur, Malaysia (n=272). Data was collected by administering the structured questionnaire.Results and Discussion:Results showed that 49.3% of the epilepsy patients were non-adherent to their prescribed regimen. Univariate analysis showed significant associations between medication adherence and the following factors: race, seizure frequency, overall patient satisfaction, medication taste and smell, medication cost and physical appearance, medication effectiveness, complexity of medication regimen, patient barrier, patient understanding, patient role functioning, patient positivity, vitality and general interest. Multiple regression analysis indicated that factors that are influencing medication adherence are seizure frequency (P = 0.048), overall patient satisfaction (P = 0.043) and patient understanding about their illness (P = 0.001). The model chosen for testing the relationship between medication adherence and its associated factors give an R2 value of 25.2% with an adjusted R2 of 21.4%. The F value was also significant (P = 0.000). Based on the research findings, the researchers recommends that clinicians need to play a vital role in educating the patients on their disease conditions. By educating the patients on nature of epilepsy, different modalities of treatment and benefits of adherence to treatment will help in the better adherence and management.

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“…Therefore, compliance is a key contributor to suboptimal management. [8] The terms compliance and adherence will be used synonymously in this study.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

Molugulu¹,

Gubbiyappa²,

Murthy³

et al. 2016

J Basic Clin Pharma

View full text Add to dashboard Cite

show abstract

“…If the correct cause of death can be reported on certificates, the true incidence of SUDEP may be found to be much higher than currently reported [ 12 ]. Following the increasing awareness of SUDEP, in 2013, two American states (New Jersey and Illinois) signed SUDEP measures into law requiring medical examiners to find out about potential history of epilepsy as part of the autopsy.…”

Section: Reporting Sudepmentioning

confidence: 99%

Sudden Unexpected Death in Epilepsy: Addressing the Challenges

Smithson

Colwell

Hanna

2014

Curr Neurol Neurosci Rep

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Epilepsy is associated with a higher rate of premature death than the general population, and the commonest cause of epilepsy mortality is sudden unexpected death in epilepsy (SUDEP). It is difficult to quantify because of the variable reporting of this cause of death. Death occurs due to autonomic deregulation of cardio-respiratory pathways as a result of seizures. Measures to reduce cardio-respiratory dysfunction are discussed together with the importance of seizure control in preventing SUDEP. The role of seizure detection devices, antiepileptic drugs and the importance of providing information about SUDEP to people with epilepsy are highlighted. There is increasing interest in SUDEP and some current initiatives are discussed.

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“…Despite some progress, SUDEP remains a significant clinical problem. Unfortunately, all the risk factors, mechanisms, and specific methods to prevent SUDEP are yet to be found 54 . Structural, functional and genetic factors are probable involved, and specific brain regions may be directly related.…”

Section: Cerebellar and Autonomic Processmentioning

confidence: 99%

Sudden death in a child with epilepsy: potential cerebellar mechanisms?

Arida

Sakamoto

Harper

2011

Arq. Neuro-Psiquiatr.

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Epilepsy is the most common neurological disorder in humans. People with epilepsy are more likely to die prematurely than those without epilepsy, with the most common epilepsy-related category of death being sudden unexpected death in epilepsy (SUDEP). The central mechanisms underlying the fatal process remain unclear, but cardiac and respiratory mechanisms appear to be involved. Recently, cerebellar, thalamic, basal ganglia and limbic brain structures have been shown to be implicated in respiratory and cardiac rate regulation. We discuss here the potential mechanisms underlying the fatal process, with a description of cerebellar actions likely failing in that SUDEP process. Key words: SUDEP, epilepsy, cerebellum, respiratory mechanisms, seizures.Morte súbita em uma criança com epilepsia: potenciais mecanismos cerebelares? RESUMO Epilepsia é uma das doenças neurológicas mais comuns em seres humanos. Pessoas com epilepsia têm maior chance de morrer prematuramente do que pessoas sem epilepsia, sendo a principal causa de óbito a morte súbita em epilepsia (SUDEP). Os mecanismos centrais envolvidos neste processo fatal não são claros, mas mecanismos cardíacos e respiratórios parecem estar envolvidos. Recentemente, regiões cerebrais como o cerebelo, núcleos talâmicos, gânglios basais e estruturas límbicas foram relacionadas com a variação das frequências cardíaca e respiratória. Aqui, discutiremos potenciais mecanismos envolvidos na SUDEP, com uma descrição do possível papel do cerebelo na sua ocorrência. Palavras-chave: SUDEP, epilepsia, cerebelo, mecanismos respiratórios e crises.

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Epilepsy and sudden death: Personal reflections and call for global action

Cited by 16 publications

References 102 publications

Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

Sudden Unexpected Death in Epilepsy: Addressing the Challenges

Sudden death in a child with epilepsy: potential cerebellar mechanisms?

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