SUDEP (Sudden Unexplained Death in Epilepsy Patients)
In spite of modern science and treatment, the population with epilepsy has a mortality rate up to 3 times greater than that of the general population. Studies show that epilepsy-associated deaths account for 12-15% of all sudden deaths reported. Of these, it is estimated that 2.8-11.7% are suicides; the rest are labeled as either drownings or "unexplained deaths". Unexplained deaths are ones that occur without any obvious clinical or pathological explanations. They account for 10% of all epilepsy-related deaths; 85% of these fatalities occur between the ages of 20-50 years. Usually, these people have at least a 2-year history of epilepsy. In many cases, the patients are found lying in bed or on the floor with no evidence of a seizure having occurred. It is possible that many such deaths are the result of an irreversible cardiac arrest of some sort. Such attacks have been witnessed in emergency rooms, where doctors were completely defenseless to the oncoming arrest and unable to resuscitate the patient. If a seizure is observed, generalized tonic-clonic convulsions are usually reported.
There are definite links between unexplained deaths and alcohol abuse, as well as with poor compliance with antiepileptic medication. Autopsies reveal that, at the time of death, 50% of affected patients had blood concentrations either below therapeutic levels or in completely undetectable amounts.
The chances of dying of SUDEP are remote. The incidence of SUDEP stands at approximately 1 in 1000 people with epilepsy per year. Subgroups bearing a higher risk do exist. For example, patients who take multiple AEDs (especially combined with psychiatric agents) may have an increased risk of up to 1/100 per year.
Precautionary measures can be taken to reduce the chances of SUDEP. It is most often seen in patients with poorly controlled seizures, and does not occur when seizures are well controlled. It is important, then, that people living with seizures adopt a healthy lifestyle which will minimize attacks, and take their medications regularly.
|
