Risk factors associated with increased risk for sudep risk are frequent gtc seizures, polytherapy, early onset, long duration of epilepsy, frequent. Sudden unexpected death in epilepsy epilepsy society. Update on the genetic basis of sudden unexpected death in epilepsy. For many people, epilepsy is a condition which can be wellmanaged and. A risk for sudden death in epilepsy that often goes unmentioned. The national sentinel audit of epilepsyrelated deaths in 2002 recorded 1200 epilepsyrelated deaths annually in the uk, of which 42% were felt to be avoidable. Patients with uncontrolled seizures are at greatest risk for sudep, and experiencing tonicclonic seizures, taking multiple antiepileptic drugs and having coexisting. We have analyzed 66 cases of sudden unexpected death sud in persons with seizure disorders, which were examined by the office of the medical examiner, cook county chicago. It is commonly associated with a history of generalized tonicclonic seizures, and. Treatments to prevent sudden unexpected death in epilepsy. 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. Sudep deaths are often unwitnessed with many of the. Etphiladelphia, december 7, 2015 the leading cause of epilepsyrelated death is a poorly understood phenomenon known as sudden.
Sudep is defined as the sudden, unexpected, witnessed or unwitnessed, nontraumatic, and nondrowning death in patients with epilepsy with or without. Sudden unexpected death in epilepsy sudep is a leading cause of mortality associated with epilepsy. Sudep is the sudden unexpected death of a person with epilepsy. Sudep accounts for 817% of deaths in patients with epilepsy. The term sudden unexpected death in epilepsy, or sudep, encompasses sudden unexpected, witnessed or unwitnessed, nontraumatic and nondrowning deaths in epileptic patients where postmortem. Sudden unexpected death in epilepsy sudep is a fatal complication of epilepsy. Changing communication around sudden unexpected death in epilepsy sudep embargoed for release until december 8, 2014 8. The majority of persons with epilepsy develop lasting remission from seizures, although mortality is significantly greater than that of the agematched general population. Patients with epilepsy have an increased mortality rate compared to the general population, to which sudden unexpected death in epilepsy sudep is a major contributor. The magnitude of the problem of sudden unexplained death in epilepsy is unrecognized in both the medical and lay communities. Appleton the roald dahl eeg unit, the royal liverpool childrens hospital alder hey, liverpool, l12 2ap, uk sudden. Sudden unexpected death in epilepsy sudep is the most common cause of death related to epilepsy and is associated with treatment resistance and the presence of generalised tonicclonic seizures. Sudep is defined as sudden, unexpected, nontraumatic, nondrowning death in an individual with epilepsy, witnessed or unwitnessed, in which postmortem examination does not reveal. Update on sudden unexpected death in epilepsy sudep.
Sudden unexpected death in epilepsy danny did foundation. Sudden unexpected death in epilepsy sudep is most often associated with the occurrence of generalized tonicclonic seizures gtcs, a seizure type that can now be detected with high. The stories of these two children, based on real cases under study, demonstrate the range of children at risk for sudden unexpected death in. Sudden unexpected death in epilepsy sudep is probably the most common direct epilepsy related cause of death. Pdf prevention of sudden unexpected death in epilepsy. Learn about incidence rates and risk factors of sudden unexpected death in epilepsy also called sudep. Sudden, unexpected death in epilepsy refers to a death in a patient with epilepsy that is not due to trauma, drowning, status epilepticus, or other known causes but for which there is often evidence of an. Preventing sudden unexpected death in epilepsy epilepsy. Ranking the leading risk factors for sudden unexpected death in.
Sudep is the occurrence of generalized tonicclonic seizures gtcs. Epilepsy is one of the most common neurological disorders and affects approximately 50 million people worldwide. Although largely neglected in earlier literature, sudden unexpected death in epilepsy sudep is the most important epilepsyrelated mode of death, and is the leading cause of death in. Sudden unexpected death in epilepsy sudep has gained increased awareness over the last 23 decades. Embargoed for release until december 7, 2015 at 11. There are many potential reasons for sudden unexpected death in epilepsy sudep. Adults, elderly, children, and infants are at risk. A preventable cause of sudden unexpected death in epilepsy. Sudep is the sudden, unexpected death of someone with epilepsy, who was otherwise healthy.
Sudden unexpected death in epilepsy most frequently occurs in people with chronic epilepsy, and seems to be a seizurerelated event. Sudden unexpected death in epilepsy pdf ammedicine. Sudep is sudden unexpected death in someone with epilepsy, who was otherwise well, and in whom no other. Sudden unexpected death in epilepsy sudep refers to the death of a person with epilepsy that is sudden, unexpected and unexplained. Sudden unexpected death in epilepsy sudep represents a significant. Mortality because of epilepsy is a major concern worldwide. Individuals with epilepsy have a mortality rate 2 to 3 times that of the general population, attributable both to any underlying disease that may be causing epilepsy and to the epilepsy itself.
Sudep refers to deaths in people with epilepsy that are not caused by injury, drowning, or other known causes. One very simple cause is an electrical abnormality in the heart. Aes position statement on sudep counseling american epilepsy. Sudden unexpected death in epilepsy sudep epilepsy. The american academy of neurology and american epilepsy society have. Sudden unexpected death in epilepsy incidence rates and risk factors. For some people living with epilepsy, the risk of sudden unexpected death in epilepsy sudep is an important concern. Sudep refers to unexpected, witnessed or unwitnessed, nontraumatic, and nondrowning. Sudep refers to deaths in people with epilepsy that are not caused.
Mechanisms and new methods for analyzing risks builds on earlier works focusing on the clinical problem of sudden unexpected death in epilepsy sudep. Sudep is the most common epilepsyrelated cause of death, with around 1 to 2 deaths per patients per year. People with epilepsy face a significantly increased risk of death from direct effects of seizures as well as indirect effects of epilepsy and its treatment. This book presents a methodology for identifying and classifying clusters of risks that lead to sudep.
Sudden unexpected death in epilepsy postgraduate medical. Sudden unexpected death in epilepsy refers to sudden death of an individual with a clinical history of epilepsy, in whom a postmortem examination fails to uncover a gross anatomic, toxicologic, or. A sudden death in an individual with epilepsy with a clear cause of death other than sudep e. Sudden unexpected death in epilepsy sudep is the sudden unexpected. Unraveling the genetic basis of sudden unexpected death in. Sudden unexpected death in epilepsy sudep although sudden unexpected deaths can occur in the population of people without epilepsy, some people with epilepsy are at higher risk of this occurring. Sudden unexpected death in epilepsy sudep refers to the sudden death of a seemingly healthy individual with epilepsy, usually occurring during, or immediately after, a tonicclonic seizure.
Sudden, unexpected death in epilepsy orrin devinsky, m. One way to lessen your risk of sudep is to have as few seizures as possible. This sudden unexpected death in epilepsy sudep is uncommon and in some cases may be preventable. Neurologists say sudden unexpected death in epilepsy is second to stroke as a cause of years of life lost because of a. Doctors call it sudden unexpected death in epilepsy or sudep. Changing communication around sudden unexpected death. Sudep is defined as the sudden, unexpected, witnessed or unwitnessed, non traumatic, and nondrowning death in patients with epilepsy with or without. It is defined as the sudden and unexpected, nontraumatic and nondrowning death of a person with epilepsy, without a. Sudep is generally defined as the sudden, unexpected, witnessed or unwitnessed, non. In sudep cases, no other cause of death is found when an autopsy is done. The stories of these two children, based on real cases under study, demonstrate the range of children at risk for sudden unexpected death in epilepsy sudep. Sudden unexpected death from epilepsy documentary youtube.
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