Sudden unexpected death in epilepsy in children

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy‐related mortality in children and adults living with epilepsy. The incidence of SUDEP is comparable in both children and adults; it is approximately 1.2 per 1000 person years. The pathophysiology of SUDEP is not well unders...

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Published in:Developmental medicine and child neurology 2023-09, Vol.65 (9), p.1150-1156
Main Authors: Whitney, Robyn, Sharma, Suvasini, Ramachandrannair, Rajesh
Format: Article
Language:English
Subjects:
Adult
Child
Death, Sudden - epidemiology
Death, Sudden - etiology
Death, Sudden - prevention & control
Epilepsy, Reflex
Humans
Risk Factors
Seizures - complications
Sudden Unexpected Death in Epilepsy - epidemiology
Sudden Unexpected Death in Epilepsy - etiology
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Summary:Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy‐related mortality in children and adults living with epilepsy. The incidence of SUDEP is comparable in both children and adults; it is approximately 1.2 per 1000 person years. The pathophysiology of SUDEP is not well understood but may involve mechanisms such as cerebral shutdown, autonomic dysfunction, altered brainstem function, and cardiorespiratory demise. Risk factors for SUDEP include the presence of generalized tonic–clonic seizures, nocturnal seizures, possible genetic predisposition, and non‐adherence to antiseizure medications. Pediatric‐specific risk factors are not fully elucidated. Despite recommendations from consensus guidelines, many clinicians still do not follow the practice of counseling their patients about SUDEP. SUDEP prevention has been an area of important research focus and includes several strategies, such as obtaining seizure control, optimizing treatment regimens, nocturnal supervision, and seizure detection devices. This review discusses what is currently known about SUDEP risk factors and reviews current and future preventive strategies for SUDEP. This invited review is commented on by Mastrangelo et al. on pages 1134–1135 of this issue.
ISSN:0012-1622
1469-8749
DOI:10.1111/dmcn.15553