Sunday, September 5, 2010

What is SUDEP?

SUDEP is: Sudden Unexplained Death in Epilepsy

It is generally defined as a "uncommon and non-traumatic death that occurs suddenly and unexpectedly in patients with epilepsy who otherwise were previously healthy".

It is without any obvious clinical or pathological explanations; in many cases, the patients are found lying in bed (as if they have just stopped breathing during sleep) or on the floor with no evidence of a seizure having occurred. For this reason, it is VERY IMPORTANT that this be kept in mind anytime someone who was "previously healthy" dies.

How Common Is It?

SUDEP accounts for 10% of all epilepsy-related deaths; 85% of these fatalities occur between the ages of 20-50 years.

The incidence of SUDEP stands at approximately 1 in 1000 people with epilepsy per year, which is at least 10 times the sudden death rate found in the general population.

What that means is, if you have a diagnosis of epilepsy, you are TEN TIMES more likely to have "Sudden Death".

What Are the Suspected Causes?

Possibilities include:

An irreversible cardiac arrest (heart attack); according to one theory, electrical discharges in the brain may change the electrical status of the heart, affecting its rhythm. (SUDEP has been witnessed in hospital and Emergency Departments where doctors on the scene were unable to resuscitate the patient.)

Respiratory arrest; breathing stopped by a seizure which is generally described as a generalized tonic-clonic convulsion

What are the Risk Factors of SUDEP?

People with refractory (uncontrolled or poorly controlled) epilepsy

People with severe epilepsy and learning difficulties

Young patients with a long history of generalized tonic-clonic seizures

Having at least a 2-year history of epilepsy

People who take 2 or more anti-epileptic drugs (especially if combined with psychiatric agents)

Poor compliance with anti-epileptic medications (Autopsies reveal that, at the time of death, 50% of affected patients had blood concentrations either below therapeutic levels or in completely undetectable amounts.)

Alcohol abuse (definite links found)

Alone during seizure

Can Any Precautionary Measures Prevent SUDEP?

Controlling seizures seems to be the most important thing, however, a very few people have not survived their very FIRST seizure so PREVENTION is important.

Keep appointments so your doctor can monitor any changes, and adjust your medications accordingly

Take medications for seizures regularly

Avoid sudden drug withdrawal, or dosage changes

Adopt a healthy lifestyle:

     Maintain regular and adequate sleep patterns

     Exercise regularly

     Eat regular, nutritious meals

     Learn to cope with stress

     Avoid alcohol and street drugs

Always stay with company so that someone can help during seizure

Nocturnal Seizures - Seizures occurring during sleep have a higher incidence of SUDEP. Preventive measures might include having the bed near the floor, changing from a feather to a solid foam pillow (which may reduce the possibility of suffocation), and having a monitor to alert others in the home when a seizure occurs.

The aforementioned can be found at

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