Predicting Sudden Unexpected Death in Epilepsy

Sudden unexpected death in epilepsy (SUDEP) is an important cause of premature death, with known risk factors including male sex, obesity, sleeping or living alone, and a history of uncontrolled convulsive seizures. Nocturnal seizures, in particular, are associated with increased risk, but are there other features of seizures — such as seizure onset zone, cardiac changes, and blood oxygenation — that might also predict future occurrence of SUDEP?

To find out, researchers followed nearly 1100 adults with drug-resistant focal epilepsy who had undergone in-hospital seizure monitoring. Their analysis focused on the 18 patients who died of probable or definite SUDEP (2.6 per 1000 patient-years) and 72 matched controls.