SUDEP in adults and children

Guest Editorial

Author Details : Divya K P, Ajith Cherian*

Volume : 7, Issue : 4, Year : 2021

Article Page : 259-265

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Background: Sudden unexpected death in epilepsy (SUDEP) represents an important cause of death in patients with epilepsy and it exceeds the expected rate of sudden death in the general population by nearly 24 times.
Materials and Methods: We searched the electronic databases (Cochrane, EMBASE, Scopus, Medline, Pubmed) for studies related to etiology and risk stratification of SUDEP including data on Takotsubo cardiomyopathy (TKC) following seizures resulting in death or near death.
Results and Conclusions: SUDEP is more common among males in the fourth decade of life. Risk for SUDEP is increased by early onset of seizures, low IQ, generalised tonic clonic seizures, nocturnal seizures and seizure frequency. Nonadherance to antiepileptic medications, absence of therapeutic drug level monitoring, presence of neuropathological lesions on imaging and certain subgroups like Dravet syndrome increase its risk. The risk for premature death in patients undergoing temporal lobe resection for drug resistant epilepsy decreased over time but remained above the standard population. Prolonged postictal electroencephalographic suppression was a risk factor for SUDEP in patients with generalised seizures which may indicate a cerebral electrical shutdown. Documented ictal/postictal hypoventilation, laryngeal spasm and cardiac rhythm abnormalities prior to SUDEP may suggest central apnea, neurogenic pulmonary edema, cardiac arrhythmia, or a combination of the above as a cause. Seizure triggered TKC does not seem to play a major role in the pathogenesis of SUDEP.

Keywords: Sudden death, Mortality, Seizure, Autopsy, Takotsubo cardiomyopathy, Epilepsy

How to cite : Divya K P, Cherian A, SUDEP in adults and children. IP Indian J Neurosci 2021;7(4):259-265

Copyright © 2021 by author(s) and IP Indian J Neurosci. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (

Article History

Received : 28-11-2021

Accepted : 03-12-2021

Available online : 05-01-2022

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