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Sudden Death Can Occur in Full Spectrum of Epilepsies

Only 37 percent of patients with sudden unexpected death in epilepsy took last dose of antiseizure meds

WEDNESDAY, June 19, 2019 (HealthDay News) — Sudden unexpected death in epilepsy (SUDEP) can occur across the full spectrum of epilepsies, according to a study published online June 19 in Neurology.

Chloe Verducci, from New York University School of Medicine in New York City, and colleagues reviewed all cases referred to the North American SUDEP Registry (NASR) between October 2011 and June 2018.

The researchers identified 237 definite and probable cases of SUDEP among 530 NASR participants. The median age at death was 26 years, and 38 percent of SUDEP decedents were female. Forty and 60 percent of the 143 decedents with sufficient information had generalized and focal epilepsy, respectively. SUDEP affected the full spectrum of epilepsies, ranging from 1 percent in benign epilepsy with centrotemporal spikes to 11 percent in intractable epileptic encephalopathies. Ninety-three percent of SUDEPs were unwitnessed; 70 percent occurred during apparent sleep, with 69 percent of patients prone. Thirty-seven percent of patients with SUDEP took their last antiseizure medication dose. The reported lifetime generalized tonic-clonic seizures were <10 in 33 percent and zero in 4 percent.

“Since sudden death can happen to anyone with epilepsy, doctors need to discuss this rare possibility with people with epilepsy and their families,” a coauthor said in a statement. “They need to understand the critical — and potentially life-saving — importance of taking their medications on time and not skipping their medications or taking less than their prescribed dose.”

Several authors disclosed financial ties to the pharmaceutical industry.

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