SUDEP - Frequently Asked Questions
What is SUDEP?
SUDEP (Sudden Unexplained Death in Epilepsy Patients)is the sudden, unexplained and unexpected death of an individual with epilepsy. The cause of death cannot be determined. When an autopsy is performed on an individual suspected of dying from SUDEP, the examination does not reveal a toxicological or anatomic cause of death. SUDEP cases were recorded as early as the 1900's but it was not understood. It has only been recent that the risk factors of SUDEP have been identified, although there is still much more research to be done.
How common is SUDEP?
SUDEP occurs in approximately 1 in 1000 people with epilepsy per year. Those who take multiple anticonvulsant drugs could increase their risk up to 1 in 100 people per year. SUDEP accounts for 12-15% of deaths in people with epilepsy. People with epilepsy have an increased death rate of three times compared to the rate of the general population.
What are the risk factors associated with SUDEP?
In the cases of SUDEP that have been examined, there are common factors that link these cases. These include:
- forgetting to take anticonvulsant drug dosages or not taking them at all
- taking more than one type of anticonvulsant drug
- frequent switches of anticonvulsant drugs
- having poor seizure control
- having seizures during sleep
- being alone at the time of a seizure
- experiencing tonic-clonic seizures
- having brain damage
- being a young adult, particularly male
- excessive consumption of alcohol
In 39 cases of SUDEP that were examined, 92% had blood anticonvulsant levels below the recommended range. It is also a known fact that the more severe the epilepsy, the higher the risk of SUDEP.
What causes SUDEP?
There is no specific known cause of SUDEP but research has been done and there is a possibility that it is related to a weakness in the heart and lungs. The possible causes of SUDEP that are related to cardiac and respiratory function could be the following: During a tonic-clonic seizure, the individual may stop breathing. After the seizure is over, regulated breathing returns but in some cases it may not return and the individual will need to be put on life support or else they will die. Also, when a person experiences a seizure, the part of the brain that controls the rhythm of the heart may be affected. This could cause an abnormal heartbeat. In some cases, the heartbeat could be so unstable that the heart could stop beating causing cardiac arrest. Further research into the connection between the heart and SUDEP must be done to look for a definite link.
What can be done to prevent SUDEP from occurring?
The best way to prevent SUDEP from occurring is by minimizing or eliminating the risk factors that are associated with SUDEP. Since most cases of SUDEP occur when the person is alone or sleeping, it is advisable to try and avoid being alone for long periods of time. It is also good to avoid high-risk environments such as heights and swimming pools. The most important thing to do is to have control over your seizures since SUDEP is most often seen in patients with poorly controlled seizures. This can be done by taking anticonvulsant medication regularly and living a healthy lifestyle. A healthy lifestyle means adequate amount of sleep, a positive mental state, reduced stress levels and having a good nutritious diet. For further information on understanding and controlling your seizures, talk to your doctor.
Works Cited
Thanks to HRDC (Human Resource Development Canada) Summer Career Placement Program, and to Nisha Gupta for compiling this article.
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