SUDEP, sudden death in epilepsy, has
an incidence of 1-2 cases per 1,000 patients with epilepsy per year.1
The recent tragic death of Cameron Boyce, a popular 20 year-old Disney star, has brought SUDEP and epilepsy to the
public eye.
A study reviewed 237 SUDEP cases between
October 2011 and June 2017 in the North American SUDEP Registry. Subjects were ages
1-70 years, the median age was 26. Women made up 38% of the study population.2
Researchers found that night sleep,
usually considered the usual situation related to SUDEP deaths, is not
necessarily the most common time when SUDEP occurs. Many patients in this
registry died during daytime. Additionally, the mechanism of death may not be
due to an obstruction of the airways but more likely is related to cardio-respiratory
phenomena.
The study showed all ages and all
epilepsy severeties are affected by SUDEP; it is not restricted to chronic
poorly-controlled epilepsies. Anybody with epilepsy can experience SUDEP
including patients with well-controlled or benign epilepsies, i.e., those with
centrotemporal EEG spikes (the Rolandic Epilepsies that primarily occur during
sleep and not while awake). The reported lifetime number of generalized tonic-clonic
grand mal seizure counted in the study population ranged from zero to more than
500.
The most notable observation in the
study was that a majority of these deaths occurred in people who did NOT take their last dose of antiseizure
medication. This presents a chance to minimize the risk of SUDEP. Take your medications as prescribed!
Physicians need to discuss the risk
of SUDEP with their patients, emphasizing the importance of never skipping an antiseizure
medication dose. If your doctor doesn’t bring SUDEP up, YOU, the patient, should
ask about it. Minimize alcohol and, additionally, get enough sleep.
Epilepsy surgery can be curative of
epilepsy if you are a candidate. Discuss this option with your doctor. The
shorter time interval between the onset of your epilepsy and the epilepsy
surgery can achieve better results from surgery.3
1) Thurman
DJ, Hesdorffer DC, French JA. Sudden
unexpected death in epilepsy: assessing the public health burden. Epilepsia
2014;55: 1479-85.
2) Verducci
C, Hussain F, Donner E et. al. SUDEP in
the North American SUDEP Registry: the full spectrum of epilepsies.
Neurology 2019;93:e226-e236.
3) Bjelivi
J, Olsson I, Malmgren K, et. al. Epilepsy
duration and seizure outcome in epilepsy surgery. Neurology
2019;93:e159-e166.
