Sudden unexpected death in epilepsy patients: Risk factors

Monté, C.P.J.A.; Arends, Johan; Tan, In Y.; Aldenkamp, Albert P.; Limburg, M.; Krom, M.C.T.F.M. de

doi:10.1016/j.seizure.2006.10.002

Cited by 95 publications

(69 citation statements)

References 57 publications

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“…Once more, gender was not found to be a significant factor for reciprocal social interaction. The literature review does suggest that males are vulnerable to a more severe presentation of epilepsy (Monte et al, 2007). However, gender differences in AED intervention may compensate to level these differences.…”

Section: Discussionmentioning

confidence: 98%

Autistic characteristics in adults with epilepsy

Wakeford

Hinvest

Ring

et al. 2014

Epilepsy & Behavior

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Section: Discussionmentioning

confidence: 98%

Autistic characteristics in adults with epilepsy

Wakeford

Hinvest

Ring

et al. 2014

Epilepsy & Behavior

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“…Using prior evidence, it was hypothesised that social and material deprivation, recent discontinuation of anticonvulsant drugs, treatment for depression, a history of injuries, and a failure to remain seizure free might be associated with mortality in epilepsy. 7 A nested case-control study was implemented to test these hypotheses.…”

Section: Introductionmentioning

confidence: 99%

Epilepsy mortality and risk factors for death in epilepsy: a population-based study

Ridsdale¹,

Charlton²,

Ashworth³

et al. 2011

Br J Gen Pract

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BackgroundEpilepsy is an important cause of amenable mortality but risk factors for death in epilepsy are not well understood. AimTo evaluate trends in epilepsy mortality in a large population and identify risk factors for death in epilepsy. Design and settingNested case-control study in the UK, using data from the General Practice Research Database (GPRD) from 1993 to 2007. MethodParticipants were included if they had ever been diagnosed with epilepsy and prescribed anticonvulsant drugs. Trends in all-cause mortality in persons with epilepsy in the GPRD were compared with death registrations with epilepsy as the underlying cause. A nested case-control study was implemented to compare participants with epilepsy who died with those who did not die. ResultsThe prevalence of epilepsy increased from 9 per 1000 in 1993 to 12 per 1000 in 2007, and epilepsy deaths also increased in this period. In a nested case-control study, mortality was associated with: recorded alcohol problems (odds ratio [OR] 2.96, 95% confidence interval [CI] = 2.25 to 3.89, P<0.001); having collected the last anticonvulsant prescription 90-182 days previously (OR 1.83, CI = 1.66 to 2.03, P<0.001); having an injury in the previous year (OR 1.41, 95% CI = 1.30 to 1.53, P<0.001), and having been treated for depression (OR 1.39, 95% CI = 1.28 to 1.50, P<0.001). In data available from 2004 onwards, being recorded seizure free in the previous 12 months was associated with lower mortality (OR 0.78, 95% CI = 0.71 to 0.86, P<0.001). ConclusionMortality with epilepsy appears to be increasing. Patients who have alcohol problems, do not collect repeat prescriptions for anticonvulsant drugs, have recent injuries, or have been treated for depression may be at increased risk of death; patients who remain seizure free over 12 months are at a lower risk.Keywords cohort study; epilepsy mortality; epilepsy prevalence; nested case-control study; primary care. as 'up to standard' when they are of a quality that is high enough to be used in research. Several studies have evaluated the validity of clinical diagnoses recorded in the GPRD with, generally, satisfactory results. Herrett et al found that the median proportion of GPRD cases with a confirmed diagnosis in validation studies was 89%. 8For this study, participants who had been diagnosed with epilepsy at some point in their life and had received one or more prescriptions for anticonvulsant drugs were selected. Medical diagnoses for epilepsy were identified using a list of 186 Read and Oxford Medical Information Systems Codes for epilepsy; details of the codes are available from the authors. Anticonvulsant prescriptions were identified using multilex codes for drugs included in section 4.8.1 of the British National Formulary.9 These included beclamide, carbamazepine, clobazam, ethosuximide, fospheytoin, gabapentin, lacosamide, lamotrigine, levetiracetam, mesuximide, methylphenobarbital, oxcarbazepine, phenobarbital, phenytoin, pregabalin, primidone, rufinamide, sodium valproate, stiripentol, su...

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“…[28] In further support of the preventive effect of AED treatment, poor compliance has frequently been suggested as a risk factor for SUDEP. [29][30][31] Data are, however, so far somewhat conflicting which may relate to methodological problems with previous studies. [32] In a retrospective cohort study, Faught and colleagues [33] used Medicaid claims data to evaluate adherence to treatment in more than 33,000 patients with AED prescriptions.…”

Section: Risk Factorsmentioning

confidence: 97%

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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Sudden unexpected death in epilepsy patients: Risk factors

Abstract: In this study, authors have designed a quality scale to select papers. The relative importance of risk factors for SUDEP is demonstrated.

Cited by 95 publications

References 57 publications

Autistic characteristics in adults with epilepsy

Autistic characteristics in adults with epilepsy

Epilepsy mortality and risk factors for death in epilepsy: a population-based study

Sudden Unexpected Death in Epilepsy (SUDEP): an overview

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