Details:

Alternative Title:
Epilepsia
Personal Author:
Lhatoo, Samden D ; Nei, Maromi ; Raghavan, Manoj ; Sperling, Michael ; Zonjy, Bilal ; ... More +
Lhatoo, Samden D ; Nei, Maromi ; Raghavan, Manoj ; Sperling, Michael ; Zonjy, Bilal ; Lacuey, Nuria ; Devinsky, Orrin Less -
Description:
Objective

To describe the phenomenology of monitored Sudden Unexpected Death in Epilepsy (SUDEP) occurring in the inter-ictal period where death occurs without a seizure preceding it.

Methods

We report a case series of monitored definite and probable SUDEP where no electroclinical evidence of underlying seizures was found preceding death.

Results

Three patients (2 definite and 1 probable) suffered SUDEP. They had a typical high SUDEP-risk profile with longstanding intractable epilepsy and frequent generalized tonic-clonic seizures (GTCS). All patients had varying patterns of respiratory and bradyarrhythmic cardiac dysfunction with profound EEG suppression. In two patients, patterns of cardio-respiratory failure were similar to those seen in some patients in the Mortality in Epilepsy Monitoring Units Study (MORTEMUS).

Significance

Sudden Unexpected Deaths in Epilepsy (SUDEP) almost always occur postictally, after GTCS and less commonly after a partial seizure. Monitored SUDEP or near-SUDEP cases without a seizure have not yet been reported in literature. When non-monitored SUDEP occurs in an ambulatory setting without an overt seizure, the absence of EEG information prevents the exclusion of a subtle seizure. These cases confirm the existence of non-seizure SUDEP; such deaths may not be prevented by seizure detection based devices. SUDEP risk in epilepsy patients may constitute a spectrum of susceptibility wherein some are relatively immune, death occurs in others with frequent GTCS with one ultimately proving fatal, while in others still, death may occur even in the absence of a seizure. We emphasize the heterogeneity of SUDEP phenomena.


Subjects:
[+]
Adult Article Death, Sudden EEG Suppression Electrocardiography Electroencephalography Epilepsy Female Humans Male Middle Aged Near-SUDEP Non-seizure SUDEP SUDEP
Source:
Epilepsia. 57(7):1161-1168.
Pubmed ID:
27221596
Pubmed Central ID:
PMC5541994
Document Type:
Journal Article
Funding:
U01 NS090415/NS/NINDS NIH HHS/United States ; R01 MH094480/MH/NIMH NIH HHS/United States ; U01 NS090407/NS/NINDS NIH HHS/United States ; U48 DP005008/DP/NCCDPHP CDC HHS/United States ; U01 NS090405/NS/NINDS NIH HHS/United States ; ... More +
U01 NS090415/NS/NINDS NIH HHS/United States ; R01 MH094480/MH/NIMH NIH HHS/United States ; U01 NS090407/NS/NINDS NIH HHS/United States ; U48 DP005008/DP/NCCDPHP CDC HHS/United States ; U01 NS090405/NS/NINDS NIH HHS/United States ; R01 EB018308/EB/NIBIB NIH HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:08232783774422457a244464cfc78b156b2e9e4cef450ca16cad1696b8eb9d2d
Download URL:
https://stacks.cdc.gov/view/cdc/47331/cdc_47331_DS1.pdf
File Type:

Supporting Files

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