Expert calls for awareness, research of sudden death in patients with epilepsy

Over time, epileptic seizures can lead to major health issues, including significant cognitive decline and even death, warns Orrin Devinsky, MD, professor, Departments of Neurology, Neurosurgery and Psychiatry at NYU Langone Medical Center. In a review article in the Nov. 10, 2011 issue of the New England Journal of Medicine, Devinsky addresses the magnitude of sudden, unexpected death in epilepsy (SUDEP) and offers guidance to patients, physicians and families of those with epilepsy about the risk factors, possible causes and interventional measures.

"Although most people with epilepsy live full and productive lives, doctors may too readily assure patients that seizures will never hurt the brain and are never fatal," writes Devinsky. "If patients are aware that seizures can be deadly, they may be more motivated to adhere to antiepileptic and avoid that increase the likelihood of them."

According to the article, SUDEP usually occurs in chronic, severe cases of epilepsy. But it is estimated that 2.7 million Americans suffer from some form of epilepsy and, even under , 25 percent of these patients fail to achieve adequate control of their seizures, making therapies less effective and requiring more intensive and comprehensive care than is available through a regular neurologist.

According to Devinsky, the rate of SUDEP increases with the duration and severity of epilepsy. While the exact mechanisms are not known, Devinsky identifies several risk factors associated with known cases of SUDEP, which includes a high prevalence of seizure just prior to an event, an impaired respiratory condition, slowing or shutting down of cerebral functions and .

Devinsky points to a long-term cohort study conducted in Finland of 245 patients diagnosed with epilepsy as children – which found that SUDEP may have been responsible for 38 percent of the 60 deaths that occurred over the 40 year span. The overall incidence of SUDEP is likely underestimated, adds Devinsky, because of incomplete databases and the fact that the cause may not be appropriately identified by coroners, medical examiners and physicians who are unaware of the diagnostic criteria for SUDEP. A reduction in sudden deaths among patients with epilepsy may be achieved through:

-- Increased awareness by the general public and medical community
-- Improved prevention and treatments of epilepsy
-- Further development and use of devices that detect seizures and can alert caretakers
-- Improved understanding of the mechanisms of SUDEP
-- Conducting interventional trials to prevent the progression of life-threatening seizure to sudden death

add to favorites email to friend print save as pdf

Related Stories

Treatment-resistant epilepsy common in idiopathic autism

Apr 19, 2011

A new study found that treatment-resistant epilepsy (TRE) is common in idiopathic autism. Early age at the onset of seizures and delayed global development were associated with a higher frequency of resistance to antiepileptic ...

Heart link discovered in sudden epilepsy deaths

Nov 08, 2010

(PhysOrg.com) -- Sudden unexpected death in epilepsy (SUDEP) is the most common cause of epilepsy-related death and responsible for about 150 Australian deaths each year yet the underlying cause has remained a mystery.

Gene identified for sudden unexpected death in epilepsy

Apr 13, 2010

A mutation in a brain protein gene may trigger irregular heart beat and sudden death in people with epilepsy, according to new research in the April 14 issue of The Journal of Neuroscience. People with epilep ...

Recommended for you

Nigeria confirms two new Ebola cases (Update)

1 hour ago

Two new cases of Ebola have emerged in Nigeria and, in an alarming development, they are outside the group of caregivers who treated an airline passenger who arrived with Ebola and died, Health Minister Onyebuchi ...

Senegal closes border as UN warns on Ebola flare-up

6 hours ago

Senegal has become the latest country to seal its border with a west African neighbour to ward off the deadly Ebola virus, as the new UN pointman on the epidemic said preparations must be made for a possible flare-up of the ...

Climate change could see dengue fever come to Europe

6 hours ago

Dengue fever could make headway in popular European holiday destinations if climate change continues on its predicted trajectory, according to research published in open access journal BMC Public Health.

American Ebola doc: 'I am thrilled to be alive'

14 hours ago

Calling it a "miraculous day," an American doctor infected with Ebola left his isolation unit and warmly hugged his doctors and nurses on Thursday, showing the world that he poses no public health threat ...

User comments