Sudden unexplained death in children with epilepsy

Donner, Elizabeth; Smith, Charles R.; Snead, O. Carter

doi:10.1212/wnl.57.3.430

Cited by 169 publications

(159 citation statements)

References 20 publications

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“…W większo-ści przypadków dochodzi do tego w nocy lub podczas snu, bez świadków zdarzenia [650]. Największym czynnikiem ryzyka SUDEP są częste drgawki, a zwłaszcza uogólnione drgawki toniczno-kloniczne [651][652][653][654][655][656][657][658][659][660].…”

Section: Nagły Niewyjaśniony Zgon W Przebiegu Padaczkiunclassified

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Priori

Blomström‐Lundqvist²,

Mazzanti³

et al. 2015

Kardiol Pol

233

337

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Section: Nagły Niewyjaśniony Zgon W Przebiegu Padaczkiunclassified

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Priori

Blomström‐Lundqvist²,

Mazzanti³

et al. 2015

Kardiol Pol

233

337

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“…Over the years, further refinements to knowledge of SUDEP incidence have been made. Briefly, it has been reported that SUDEP is responsible for up to 17% of all deaths in epilepsy 33 with an incidence rate among adults between 1:500 and 1:1,000 patient-years while in children SUDEP varies on average 2/10.000 patient-years 33,34 . WHY?…”

Section: Sudden Cardiac Death In Epilepsy Disappoints But Epileptolomentioning

confidence: 99%

Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith

Scorza

Cavalheiro

Costa

2016

Arq. Neuro-Psiquiatr.

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Sudden cardiac death in epilepsy disappoints, but epileptologists keep faithApesar do desapontamento com a morte súbita cardíaca nas epilepsias, os epileptologistas mantêm a fé The first formal description of sudden cardiac death (SCD) was made as early as 4 th century BC by the father of medicine, Hippocrates of Kos, which stated in his aphorisms that those who are subject to frequent and severe fainting attacks without obvious cause die suddenly 1,2 . Presently, in most textbooks SCD is defined as an unexpected death occurring within one hour from onset of symptoms in an individual with stable clinical conditions before the onset of the life-threatening arrhythmic event 3,4,5 . The magnitude of the problem is reflected on the fact that more than 7 million lives per year are lost to SCD worldwide 1 . In Europe, approximately 350,000 individuals die each year due to SCD with unsuccessful out-of-hospital cardiopulmonary resuscitation 6,7 . The incidence of SCD in the United States ranges between 180,000 and 450,000 cases annually, depending on the definition used 4,5,8,9,10 . In a more specific way, prospective studies using multiple sources developed in the United States, Netherlands, Ireland, and China have shown that SCD rates ranging from 50 to 100 per 100 000 in the general population 10,11,12,13,14,15,16 . The global burden of SCD remains high despite the fact that several factors have already been described which increase the risk of SCD in the general population 9,10 . It should not be ignored that epilepsy and seizures can have a profound effect on cardiovascular function and in some cases may be fatal 17,18 . A number of questions should be raise to elucidate clearly the exact relationship between SCD and epilepsy.WHERE? Epilepsy is one of the most common neurological conditions affecting at least 65 million people worldwide 19,20 . Individuals of all ages can be affected by it. It is treatable but often requires lifelong medication and sometimes surgery to control seizures 21,22 . Despite this, seizures in up to 40% of people with epilepsy do not respond properly to antiepileptic drugs or other treatments 23 . In these individuals with refractory epilepsy, high rates of premature death compared with the general population have recorded 24,25 . Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in those people 26 . WHAT? The lack of autopsy results and AbStrACtSudden unexpected death in epilepsy (SUDEP) is the most common cause of death in people with intractable epilepsy. Probably, optimization of seizure control will prevent some of these deaths. Briefly, we integrated in this paper some data about the epidemiology, risk factors, etiology, and preventative measures in the management of SUDEP.Keywords: epilepsy; death, sudden. reSumoA morte súbita nas epilepsias (SUDEP) é a causa mais comum de morte em indivíduos com epilepsia refratária. Provavelmente, o controle das crises epilépticas irá evitar algumas dessas mortes. Resumidamente, nós descrevemos nesse artigo alguns dados sobr...

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“…The majority of deaths are unwitnessed; most series report only 10 to 20% witnessed cases, making it difficult to ascertain whether a seizure precedes death (19)(20)(21)(22). When witnessed and unwitnessed cases are considered, 50 to 90% of cases have evidence of a convulsive seizure before death (14,(19)(20)(21)(22)(23)(24) Sudden death is over 20 times more frequent in people with epilepsy than the general population. The literature on clinical risk factors is now able to define individuals at the highest risk.…”

Section: Circumstances Of Deathmentioning

confidence: 99%

Explaining the Unexplained; Expecting the Unexpected: Where Are We with Sudden Unexpected Death in Epilepsy?

Donner

2011

Epilepsy Curr

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Sudden death is over 20 times more frequent in people with epilepsy than the general population. The literature on clinical risk factors is now able to define individuals at the highest risk. Despite these advances in our understanding of risk, the mechanism of sudden unexpected death in epilepsy remains elusive. While it is unlikely that a single mechanism will be found to explain all deaths, there have been recent advances that identify factors that play a critical role. This review provides an update on new advances in the understanding of sudden unexpected death in epilepsy.

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Sudden unexplained death in children with epilepsy

Abstract: This case series represents the largest series of sudden unexplained death in children with epilepsy. At least two previously described risk factors for SUDEP in adults, low serum AED levels at time of death and AED polytherapy, do not appear to be significant in children.

Cited by 169 publications

References 20 publications

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith

Explaining the Unexplained; Expecting the Unexpected: Where Are We with Sudden Unexpected Death in Epilepsy?

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