Reducing Sudden Unexpected Death in Epilepsy: Considering Risk Factors, Pathophysiology and Strategies

Abstract Purpose of Review Sudden Unexpected Death in Epilepsy (SUDEP) is the commonest cause epilepsy-related premature mortality people with chronic epilepsy. It most devastating epilepsy outcome. We describe and discuss risk factors possible pathophysiological mechanisms to elucidate preventative strategies avert SUDEP. Recent Findings death accounts for a significant proportion compared general population. Unmodifiable include history neurologic insult, younger age seizure-onset, longer duration, convulsions, symptomatic epilepsy, intellectual disability, non-ambulatory status. Modifiable presence convulsive seizures, increased seizure frequency, timely appropriate use antiseizure medications, polytherapy, alcoholism, supervision while sleeping. Pathophysiology unclear, but several such as direct alteration cardiorespiratory function, pulmonary impairment, electrocerebral shutdown, adenosine dysfunction, genetic susceptibility suggested. Summary Methods prevent SUDEP increasing awareness SUDEP, augmenting knowledge unmodifiable factors, obtaining full remission, addressing lifestyle prone positioning, enacting protocols increase detection intervention Further studies are required characterize precisely comprehensively drivers develop evidence-based algorithms minimize