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Incidence of SUDEP in a cohort of patients with refractory epilepsy: the role of surgery and lesion localization
The aim of this study was to verify incidence and characteristics of sudden unexpected death in patients (SUDEP) with refractory epilepsy and its relation to previous surgery and lesion localization. A cross sectional study was carried out in a cohort of 550 patients with refractory epilepsy followe...
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Published in: | Arquivos de neuro-psiquiatria 2010-12, Vol.68 (6), p.898-902 |
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description | The aim of this study was to verify incidence and characteristics of sudden unexpected death in patients (SUDEP) with refractory epilepsy and its relation to previous surgery and lesion localization.
A cross sectional study was carried out in a cohort of 550 patients with refractory epilepsy followed up by the Epilepsy Surgery Program of the University Hospital of PUCRS, Porto Alegre, Brazil, between January, 1992 and July, 2002. Patients were allocated in two groups (operated and non operated). Seizure type, distribution of interictal spikes and MRI findings were correlated with the SUDEP outcome.
The estimated incidence of probable SUDEP amounted to 29:1000 individuals. Probable SUDEP occurred in 1.2% of the 166 patients of the non operated group and in 3.7% of the 384 patients who were operated (OR=3.02, 95% CI 0.69-13.16) (p=0.11). Comparing patients who died to patients alive in the operated group a significant difference was observed concerning the following variables: SUDEP patients had a predominance of generalized seizures (p=0.002), extratemporal lesion on MRI (p |
doi_str_mv | 10.1590/S0004-282X2010000600013 |
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A cross sectional study was carried out in a cohort of 550 patients with refractory epilepsy followed up by the Epilepsy Surgery Program of the University Hospital of PUCRS, Porto Alegre, Brazil, between January, 1992 and July, 2002. Patients were allocated in two groups (operated and non operated). Seizure type, distribution of interictal spikes and MRI findings were correlated with the SUDEP outcome.
The estimated incidence of probable SUDEP amounted to 29:1000 individuals. Probable SUDEP occurred in 1.2% of the 166 patients of the non operated group and in 3.7% of the 384 patients who were operated (OR=3.02, 95% CI 0.69-13.16) (p=0.11). Comparing patients who died to patients alive in the operated group a significant difference was observed concerning the following variables: SUDEP patients had a predominance of generalized seizures (p=0.002), extratemporal lesion on MRI (p<0.001) and epileptiform activity over extratemporal regions (p=0.001).
In surgically treated patients with refractory epilepsy, an extratemporal location of the lesion and of the epileptiform discharges significantly correlated to SUDEP. Thus it is possible that in those patients; the underlying disease may play a role in the pathogenesis of SUDEP.</description><identifier>ISSN: 0004-282X</identifier><identifier>ISSN: 1678-4227</identifier><identifier>EISSN: 1678-4227</identifier><identifier>EISSN: 0004-282X</identifier><identifier>DOI: 10.1590/S0004-282X2010000600013</identifier><identifier>PMID: 21243249</identifier><language>eng</language><publisher>Brazil: Academia Brasileira de Neurologia - ABNEURO</publisher><subject>Adult ; Brazil - epidemiology ; cirurgia da epilepsia ; Cross-Sectional Studies ; Death, Sudden - epidemiology ; Death, Sudden - etiology ; epilepsia extratemporal ; epilepsia refratária ; Epilepsy - complications ; Epilepsy - mortality ; Epilepsy - surgery ; Female ; Humans ; Incidence ; Male ; NEUROSCIENCES ; PSYCHIATRY ; Risk Factors ; SUDEP ; Young Adult</subject><ispartof>Arquivos de neuro-psiquiatria, 2010-12, Vol.68 (6), p.898-902</ispartof><rights>This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-f3a60da708338fd25daeb4df337c14b35d82a808969698cb85475e590bc0edc43</citedby><cites>FETCH-LOGICAL-c396t-f3a60da708338fd25daeb4df337c14b35d82a808969698cb85475e590bc0edc43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,24129,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21243249$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Almeida, Andrea Garcia de</creatorcontrib><creatorcontrib>Nunes, Magda Lahorgue</creatorcontrib><creatorcontrib>Palmini, André Luis Fernandes</creatorcontrib><creatorcontrib>Costa, Jaderson Costa da</creatorcontrib><title>Incidence of SUDEP in a cohort of patients with refractory epilepsy: the role of surgery and lesion localization</title><title>Arquivos de neuro-psiquiatria</title><addtitle>Arq Neuropsiquiatr</addtitle><description>The aim of this study was to verify incidence and characteristics of sudden unexpected death in patients (SUDEP) with refractory epilepsy and its relation to previous surgery and lesion localization.
A cross sectional study was carried out in a cohort of 550 patients with refractory epilepsy followed up by the Epilepsy Surgery Program of the University Hospital of PUCRS, Porto Alegre, Brazil, between January, 1992 and July, 2002. Patients were allocated in two groups (operated and non operated). Seizure type, distribution of interictal spikes and MRI findings were correlated with the SUDEP outcome.
The estimated incidence of probable SUDEP amounted to 29:1000 individuals. Probable SUDEP occurred in 1.2% of the 166 patients of the non operated group and in 3.7% of the 384 patients who were operated (OR=3.02, 95% CI 0.69-13.16) (p=0.11). Comparing patients who died to patients alive in the operated group a significant difference was observed concerning the following variables: SUDEP patients had a predominance of generalized seizures (p=0.002), extratemporal lesion on MRI (p<0.001) and epileptiform activity over extratemporal regions (p=0.001).
In surgically treated patients with refractory epilepsy, an extratemporal location of the lesion and of the epileptiform discharges significantly correlated to SUDEP. Thus it is possible that in those patients; the underlying disease may play a role in the pathogenesis of SUDEP.</description><subject>Adult</subject><subject>Brazil - epidemiology</subject><subject>cirurgia da epilepsia</subject><subject>Cross-Sectional Studies</subject><subject>Death, Sudden - epidemiology</subject><subject>Death, Sudden - etiology</subject><subject>epilepsia extratemporal</subject><subject>epilepsia refratária</subject><subject>Epilepsy - complications</subject><subject>Epilepsy - mortality</subject><subject>Epilepsy - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>NEUROSCIENCES</subject><subject>PSYCHIATRY</subject><subject>Risk Factors</subject><subject>SUDEP</subject><subject>Young Adult</subject><issn>0004-282X</issn><issn>1678-4227</issn><issn>1678-4227</issn><issn>0004-282X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNp9UVtrFDEUDqLYbfUvaN58mprbzCS-Sa11oaBQC76FTHKmmyU7GZMMsv560926L4KEkOTkuxzOh9BbSi5pq8j7O0KIaJhkPxih9U66uil_hla062UjGOufo9UJdIbOc94SwoRS_Ut0xigTvD5WaF5P1juYLOA44rv7T9ffsJ-wwTZuYiqPxdkUD1PJ-JcvG5xgTMaWmPYYZh9gzvsPuGwApxgOGnlJD1B_zeRwgOzjhEO0JvjfVSdOr9CL0YQMr5_OC3T_-fr71Zfm9uvN-urjbWO56kozctMRZ3oiOZejY60zMAg3ct5bKgbeOsmMJFJ1dUk7yFb0LdTRDJaAs4JfoPVR10Wz1XPyO5P2OhqvD4WYHrRJxdsAGqgbZCdgHIwRqvr3QjGn5NgbELTjVevyqJWthxD1Ni5pqs3rQwz6nxgq4d2RMKf4c4Fc9M5nCyGYCeKStRQtV20rSUX2R6RNMec63FOrlOjHqP_j8ebJYxl24E68v9nyPzgVoiU</recordid><startdate>201012</startdate><enddate>201012</enddate><creator>Almeida, Andrea Garcia de</creator><creator>Nunes, Magda Lahorgue</creator><creator>Palmini, André Luis Fernandes</creator><creator>Costa, Jaderson Costa da</creator><general>Academia Brasileira de Neurologia - ABNEURO</general><general>Academia Brasileira de Neurologia (ABNEURO)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>GPN</scope><scope>DOA</scope></search><sort><creationdate>201012</creationdate><title>Incidence of SUDEP in a cohort of patients with refractory epilepsy: the role of surgery and lesion localization</title><author>Almeida, Andrea Garcia de ; Nunes, Magda Lahorgue ; Palmini, André Luis Fernandes ; Costa, Jaderson Costa da</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-f3a60da708338fd25daeb4df337c14b35d82a808969698cb85475e590bc0edc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Brazil - epidemiology</topic><topic>cirurgia da epilepsia</topic><topic>Cross-Sectional Studies</topic><topic>Death, Sudden - epidemiology</topic><topic>Death, Sudden - etiology</topic><topic>epilepsia extratemporal</topic><topic>epilepsia refratária</topic><topic>Epilepsy - complications</topic><topic>Epilepsy - mortality</topic><topic>Epilepsy - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>NEUROSCIENCES</topic><topic>PSYCHIATRY</topic><topic>Risk Factors</topic><topic>SUDEP</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Almeida, Andrea Garcia de</creatorcontrib><creatorcontrib>Nunes, Magda Lahorgue</creatorcontrib><creatorcontrib>Palmini, André Luis Fernandes</creatorcontrib><creatorcontrib>Costa, Jaderson Costa da</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SciELO</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Arquivos de neuro-psiquiatria</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Almeida, Andrea Garcia de</au><au>Nunes, Magda Lahorgue</au><au>Palmini, André Luis Fernandes</au><au>Costa, Jaderson Costa da</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of SUDEP in a cohort of patients with refractory epilepsy: the role of surgery and lesion localization</atitle><jtitle>Arquivos de neuro-psiquiatria</jtitle><addtitle>Arq Neuropsiquiatr</addtitle><date>2010-12</date><risdate>2010</risdate><volume>68</volume><issue>6</issue><spage>898</spage><epage>902</epage><pages>898-902</pages><issn>0004-282X</issn><issn>1678-4227</issn><eissn>1678-4227</eissn><eissn>0004-282X</eissn><abstract>The aim of this study was to verify incidence and characteristics of sudden unexpected death in patients (SUDEP) with refractory epilepsy and its relation to previous surgery and lesion localization.
A cross sectional study was carried out in a cohort of 550 patients with refractory epilepsy followed up by the Epilepsy Surgery Program of the University Hospital of PUCRS, Porto Alegre, Brazil, between January, 1992 and July, 2002. Patients were allocated in two groups (operated and non operated). Seizure type, distribution of interictal spikes and MRI findings were correlated with the SUDEP outcome.
The estimated incidence of probable SUDEP amounted to 29:1000 individuals. Probable SUDEP occurred in 1.2% of the 166 patients of the non operated group and in 3.7% of the 384 patients who were operated (OR=3.02, 95% CI 0.69-13.16) (p=0.11). Comparing patients who died to patients alive in the operated group a significant difference was observed concerning the following variables: SUDEP patients had a predominance of generalized seizures (p=0.002), extratemporal lesion on MRI (p<0.001) and epileptiform activity over extratemporal regions (p=0.001).
In surgically treated patients with refractory epilepsy, an extratemporal location of the lesion and of the epileptiform discharges significantly correlated to SUDEP. Thus it is possible that in those patients; the underlying disease may play a role in the pathogenesis of SUDEP.</abstract><cop>Brazil</cop><pub>Academia Brasileira de Neurologia - ABNEURO</pub><pmid>21243249</pmid><doi>10.1590/S0004-282X2010000600013</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Brazil - epidemiology cirurgia da epilepsia Cross-Sectional Studies Death, Sudden - epidemiology Death, Sudden - etiology epilepsia extratemporal epilepsia refratária Epilepsy - complications Epilepsy - mortality Epilepsy - surgery Female Humans Incidence Male NEUROSCIENCES PSYCHIATRY Risk Factors SUDEP Young Adult |
title | Incidence of SUDEP in a cohort of patients with refractory epilepsy: the role of surgery and lesion localization |
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