S U D E P

SUDEP is an acronym that stands for Sudden Unexpected Death in Epilepsy.

Unexpected death can happen to anyone; patients with epilepsy as well as patients with no illness can be affected. In all cases, autopsy reports are inconclusive.

Before explaining what SUDEP is, it is necessary to have some background on epilepsy. As with other illnesses, epileptic seizures should be controlled. The consequences of poorly controlled seizures as well as taking unnecessary risks may lead to death.

Who is at risk?

• Adults; mean age 28-35 (rare in young children/adolescents)

Predisposing factors:

• Poorly controlled seizures (high frequency)

• Males

• Generalized tonic-clonic seizures

Other factors that may play a role:

• Recent unusually stressful life event

It is well documented that the mortality rate in persons with epilepsy is higher than in the general population. There are many causes for death relating to epilepsy, including traumatic brain injury, accidents, neoplasia (tumours), idiosyncratic (unexpected) drug reactions, apnoea, and cardiac arrhythmias. It is becoming increasingly evident that SUDEP also plays a role in many epilepsy deaths.

SUDEP, as the acronym suggests, is an unexpected death in an epileptic patient. Cases of sudden death observed in epileptic patients have been documented since the 1800s (Bacon, G.M. On The Modes of Death in Epilepsy. Lancet 1868; 1:555-556).

With the new anti-epileptic drugs being developed in the twentieth century, epilepsy was seen as a “non-fatal” illness. Patients and even many physicians were misinformed on the risks of epilepsy. Much of the research undertaken at the beginning of the century was put on hold.

As evidence regarding SUDEP deaths becomes more available and publicized, researchers can no longer be ignorant of the issue at hand. Research in the past decade has started to increase. Researchers are now continuously examining case studies to determine predisposing risk factors and similarities between SUDEP patients.