963 results match your criteria Sudden Unexpected Death in Epilepsy


Risk Factors for Sudden Unexpected Death in Epilepsy (SUDEP) and Their Mitigation.

Curr Treat Options Neurol 2019 Feb 13;21(2). Epub 2019 Feb 13.

Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.

Purpose Of Review: People with epilepsy have an increased risk of mortality when compared to the general population. Sudden unexpected death in epilepsy (SUDEP) is the most common cause of epilepsy-related death in children and adults. The purpose of this review is to discuss SUDEP, with an emphasis on SUDEP risk factors, their mitigation and prevention. Read More

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http://link.springer.com/10.1007/s11940-019-0547-4
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http://dx.doi.org/10.1007/s11940-019-0547-4DOI Listing
February 2019
4 Reads

Ventilatory response to CO in patients with epilepsy.

Epilepsia 2019 Feb 12. Epub 2019 Feb 12.

Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa.

Objective: Severe periictal respiratory depression is thought to be linked to risk of sudden unexpected death in epilepsy (SUDEP) but its determinants are largely unknown. Interindividual differences in the interictal ventilatory response to CO (hypercapnic ventilatory response [HCVR] or central respiratory CO chemosensitivity) may identify patients who are at increased risk for severe periictal hypoventilation. HCVR has not been studied previously in patients with epilepsy; therefore we evaluated a method to measure it at bedside in an epilepsy monitoring unit (EMU) and examined its relationship to postictal hypercapnia following generalized convulsive seizures (GCSs). Read More

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http://dx.doi.org/10.1111/epi.14660DOI Listing
February 2019
2 Reads

Parental perspectives on provider adherence to AAN epilepsy quality measures in rural and urban tertiary care centers.

Epilepsy Behav 2019 Feb 4;92:256-259. Epub 2019 Feb 4.

Children's National Health System, Center for Neuroscience, 111 Michigan Avenue NW, Washington, DC 10010, USA. Electronic address:

Several American Academy of Neurology (AAN) epilepsy practice guidelines recommend conversations that neurologists should have with patients and their parents. We sought to determine whether parents of pediatric patients with epilepsy had knowledge of epilepsy quality measures (EQMs) and whether they recalled having discussions with their child's neurologist about each of the EQM. Surveys were distributed to parents at five clinic sites associated with epilepsy centers in Washington, DC and Charlottesville, Virginia. Read More

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http://dx.doi.org/10.1016/j.yebeh.2019.01.009DOI Listing
February 2019
1 Read

Effect of monoamine reuptake inhibition and α blockade on respiratory arrest and death following electroshock-induced seizures in mice.

Epilepsia 2019 Feb 5. Epub 2019 Feb 5.

The Iowa Neuroscience Institute, University of Iowa, Iowa City, Iowa.

Objective: Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in patients with refractory epilepsy. Although the mechanisms for SUDEP are incompletely understood, seizure-induced respiratory arrest (S-IRA) has been strongly and consistently implicated. A body of evidence indicates that serotonin (5-HT), a modulator of breathing, plays a critical role in SUDEP. Read More

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http://dx.doi.org/10.1111/epi.14652DOI Listing
February 2019

Fenfluramine, a serotonin-releasing drug, prevents seizure-induced respiratory arrest and is anticonvulsant in the DBA/1 mouse model of SUDEP.

Epilepsia 2019 Feb 4. Epub 2019 Feb 4.

Departments of Pharmacology and Neurology, Southern Illinois University School of Medicine, Springfield, Illinois.

Objective: Prevention of sudden unexpected death in epilepsy (SUDEP) is a critical goal for epilepsy therapy. The DBA/1 mouse model of SUDEP exhibits an elevated susceptibility to seizure-induced death in response to electroconvulsive shock, hyperthermia, convulsant drug, and acoustic stimulation. The serotonin hypothesis of SUDEP is based on findings that treatments which modify serotonergic function significantly alter susceptibility to seizure-induced sudden death in several epilepsy models, including DBA/1 mice. Read More

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http://dx.doi.org/10.1111/epi.14658DOI Listing
February 2019
2 Reads

Epilepsy and Sleep Related Breathing Disturbances.

Chest 2019 Jan 31. Epub 2019 Jan 31.

Director, Cleveland Clinic Sleep Disorders Center, Cleveland, OH, US. Electronic address:

Epilepsy is the fourth most common neurological disorder in the US, affecting over 2.2 million people. Epilepsy is associated with a number of medical and psychiatric comorbidities, higher health care utilization, cost and substantial economic burden. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00123692193006
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http://dx.doi.org/10.1016/j.chest.2019.01.016DOI Listing
January 2019
4 Reads

Are there mortality risks for patients with epilepsy who use cannabis treatments as monotherapy?

Epilepsy Behav Case Rep 2019 3;11:52-53. Epub 2018 Dec 3.

Swedish Epilepsy Center, 550 17th Ave suite 540, Seattle, WA 98122, USA.

Mortality associated with cannabis used for treatment of epilepsy is not well documented. We discuss two fatalities in the setting of epilepsy and self-determined therapy with cannabis (SDTC). One patient had probable sudden unexpected death in epilepsy, the second death was due to seizure-associated drowning. Read More

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http://dx.doi.org/10.1016/j.ebcr.2018.11.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348695PMC
December 2018
1 Read

Risks and predictive biomarkers of sudden unexpected death in epilepsy patient.

Curr Opin Neurol 2019 Jan 28. Epub 2019 Jan 28.

NINDS Center for SUDEP Research and Texas Comprehensive Epilepsy Center, University of Texas Houston Health Sciences Center, Houston, Texas, USA.

Purpose Of Review: The current review updates our knowledge regarding sudden unexpected death in epilepsy patient (SUDEP) risks, risk factors, and investigations of putative biomarkers based on suspected mechanisms of SUDEP.

Recent Findings: The overall incidence of SUDEP in adults with epilepsy is 1.2/1000 patient-years, with surprisingly comparable figures in children in recently published population-based studies. Read More

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http://dx.doi.org/10.1097/WCO.0000000000000668DOI Listing
January 2019

Ictal asystole with isolated syncope: A case report and literature review.

Epilepsy Behav Case Rep 2019 24;11:47-51. Epub 2018 Nov 24.

Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198-8435, USA.

Ictal syncope is a rare phenomenon that occurs in association with 0.002-0.4% of seizures. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22133232183014
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http://dx.doi.org/10.1016/j.ebcr.2018.11.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327908PMC
November 2018
7 Reads

Fifty years' follow-up of childhood epilepsy: Medical outcome, morbidity, and medication.

Epilepsia 2019 Jan 20. Epub 2019 Jan 20.

Faculty of Medicine and Health, Department of Pediatrics, Örebro University, Örebro, Sweden.

Objective: To describe the long-term prognosis of childhood epilepsy, with special emphasis on seizure remission, relapse, medication, associated neurologic impairment, mortality rate, and cause of death.

Methods: A prospective longitudinal study on a population-based total cohort of 195 children with epileptic seizures in 1962-1964. Data were collected from medical records and a questionnaire. Read More

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http://dx.doi.org/10.1111/epi.14643DOI Listing
January 2019
6 Reads

Sudden unexpected death in epilepsy: Rethinking the unthinkable.

Epilepsy Behav 2019 Jan 17. Epub 2019 Jan 17.

Krankenanstalt Rudolfstiftung, Vienna, Messerli Institute, Veterinary University of Vienna, Vienna, Austria.

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http://dx.doi.org/10.1016/j.yebeh.2019.01.002DOI Listing
January 2019
1 Read

Sudden unexpected death in GEFS+ families with sodium channel pathogenic variants.

Epilepsy Res 2019 Feb 14;150:66-69. Epub 2019 Jan 14.

Research Institute of the McGill University Health Center, 2155 Guy Street, Montreal, PQ, H3H 2L9, Canada; Department of Pediatrics, Division of Child Neurology, Montreal Children's Hospital, McGill University Health Centre, 1001 Boulevard Décarie, Montreal, PQ, H4A 3J1, Canada.

We aimed to describe families with genetic epilepsy with febrile seizures plus (GEFS+) in which individuals suffered sudden unexpected death. The Epilepsy Pharmacogenomics Research Database was reviewed for GEFS + families in which at least one individual had suffered sudden death, and two families were identified. In Family A, five males had febrile seizures and one girl had febrile seizures plus. Read More

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http://dx.doi.org/10.1016/j.eplepsyres.2019.01.009DOI Listing
February 2019
3 Reads

Effects of enalapril and losartan alone and in combination with sodium valproate on seizures, memory, and cardiac changes in rats.

Epilepsy Behav 2019 Jan 16. Epub 2019 Jan 16.

Translational Health Science and Technology Institute, Faridabad, Haryana, India.

Purpose: Cardiac changes accompanying seizures may be responsible for sudden unexpected death in epilepsy (SUDEP), and drugs with antiseizure and favorable cardiovascular profile could be beneficial. The effect of losartan and enalapril alone and in combination with sodium valproate on seizures, cognition, cardiac histopathology, and serum brain-derived neurotropic factor (BDNF) levels were determined.

Methods: Male "Wistar" rats (200-250 g) were administered enalapril (20 mg/kg, intraperitoneally (i. Read More

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http://dx.doi.org/10.1016/j.yebeh.2018.12.019DOI Listing
January 2019
3 Reads

Brainstem spreading depolarization and cortical dynamics during fatal seizures in Cacna1a S218L mice.

Brain 2019 Feb;142(2):412-425

Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.

Sudden unexpected death in epilepsy (SUDEP) is a fatal complication of epilepsy in which brainstem spreading depolarization may play a pivotal role, as suggested by animal studies. However, patiotemporal details of spreading depolarization occurring in relation to fatal seizures have not been investigated. In addition, little is known about behavioural and neurophysiological features that may discriminate spontaneous fatal from non-fatal seizures. Read More

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http://dx.doi.org/10.1093/brain/awy325DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351775PMC
February 2019
1 Read

How can transition to adult care be best orchestrated for adolescents with epilepsy?

Epilepsy Behav 2019 Jan 11. Epub 2019 Jan 11.

Department of Pediatric Neurology, Hôpital Necker Enfants Malades, Université Paris Descartes, Institut Imagine (INSERM UMR 1163), Paris, France.

Objective evidence is limited for the value of transition programs for youth with chronic illness moving from pediatric to adult care; however, such programs intuitively "make sense". We describe the strengths and weaknesses of a variety of transition programs from around the world for adolescents with epilepsy. Consequences of poorly organized transition beyond suboptimal seizure control may include an increased risk of sudden unexpected death in epilepsy (SUDEP), poor psychological and social outcome, and inadequate management of comorbidities. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15255050183102
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http://dx.doi.org/10.1016/j.yebeh.2018.12.015DOI Listing
January 2019
13 Reads

Limbic and paralimbic structures driving ictal central apnea.

Neurology 2019 Feb 11;92(7):e655-e669. Epub 2019 Jan 11.

From the Epilepsy Center (N.L., J.P.H., J.P.M., S.L.), University Hospitals Cleveland Medical Center, OH; Department of Neurobiology and the Brain Research Institute (R.M.H.), University of California, Los Angeles; and NINDS Center for SUDEP Research (R.M.H., S.L.), Case Western Reserve University, Cleveland, OH.

Objective: To precisely identify cortical regions that modulate breathing, and delineate a network of cortical structures that underpin ictal central apnea (ICA) during epileptic seizures.

Methods: We electrically stimulated multiple cortical structures in patients undergoing stereotactic EEG (SEEG) evaluation before epilepsy surgery. Structures investigated were orbitofrontal cortex, anterior and posterior cingulate and subcallosal gyri, insula, hippocampus, parahippocampal gyrus, amygdala, temporo-polar cortex, antero-mesial fusiform gyrus, and lateral and basal temporal cortices. Read More

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http://dx.doi.org/10.1212/WNL.0000000000006920DOI Listing
February 2019
1 Read

Tonic electromyographic activity following bilateral tonic-clonic seizures is associated with periictal respiratory dysfunction and postictal generalized EEG suppression.

Epilepsia 2019 Feb 10;60(2):268-274. Epub 2019 Jan 10.

Department of Neurology, University of California Davis, Davis, California.

Objective: No biomarkers reliably predict risk for sudden unexpected death in epilepsy (SUDEP). Postictal generalized electroencephalography (EEG) suppression (PGES) is a possible biomarker for SUDEP risk. However, its utility in predicting SUDEP remains uncertain. Read More

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http://dx.doi.org/10.1111/epi.14632DOI Listing
February 2019
2 Reads

Dead in the Night: Sleep-Wake and Time-Of-Day Influences on Sudden Unexpected Death in Epilepsy.

Front Neurol 2018 11;9:1079. Epub 2018 Dec 11.

Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States.

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related death in patients with refractory epilepsy. Convergent lines of evidence suggest that SUDEP occurs due to seizure induced perturbation of respiratory, cardiac, and electrocerebral function as well as potential predisposing factors. It is consistently observed that SUDEP happens more during the night and the early hours of the morning. Read More

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http://dx.doi.org/10.3389/fneur.2018.01079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297781PMC
December 2018

Impact of repeated kindled seizures on heart rate rhythms, heart rate variability, and locomotor activity in rats.

Epilepsy Behav 2019 Jan 2;92:36-44. Epub 2019 Jan 2.

Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University (LMU), Munich, Germany. Electronic address:

Although an impact of epilepsy on circadian rhythmicity is well-recognized, there are profound gaps in our understanding of the influence of seizures on diurnal rhythms. The effect on activity levels and heart rate is of particular interest as it might contribute to the disease burden. The kindling model with telemetric transmitter implants provides excellent opportunities to study the consequences of focal and generalized seizures under standardized conditions. Read More

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http://dx.doi.org/10.1016/j.yebeh.2018.11.034DOI Listing
January 2019

Decreasing SUDEP incidence in a tertiary epilepsy center between 1981 and 2016: Effects of better patient supervision.

Epilepsy Behav 2018 Dec 20;92:1-4. Epub 2018 Dec 20.

Gesellschaft für Epilepsieforschung, Maraweg 21, D-33617 Bielefeld, Germany. Electronic address:

Objective: The objective of this study was to investigate the incidence of sudden unexpected death in epilepsy (SUDEP) in a tertiary epilepsy center in the years 1981-2016 with an emphasis on patient supervision and nursing intervention in different departments.

Methods: We identified 14 SUDEP cases (probable, definite, definite plus). Patient-years (PY) and incidence were calculated for the periods of six years for the general epileptology wards (adults and children) and, in addition, for the epilepsy monitoring unit (EMU) since 1990. Read More

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http://dx.doi.org/10.1016/j.yebeh.2018.11.019DOI Listing
December 2018

Postconvulsive central apnea and asystole: A risk marker for sudden unexpected death in epilepsy (SUDEP)?

Neurology 2019 Jan 19;92(3):115-116. Epub 2018 Dec 19.

From the Mayo Center for Sleep Medicine (E.K.S.L.); Departments of Neurology (E.K.S.L.) and Medicine (E.K.S.L.), Mayo Clinic and Foundation, Rochester, MN; and Department of Neurology (B.A.D.), Brigham and Women's Hospital, Boston, MA.

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http://dx.doi.org/10.1212/WNL.0000000000006765DOI Listing
January 2019

Postconvulsive central apnea as a biomarker for sudden unexpected death in epilepsy (SUDEP).

Neurology 2019 Jan 19;92(3):e171-e182. Epub 2018 Dec 19.

From the NINDS Center for SUDEP Research (L.V., M.R.S.R., R.K.S., D.F., M.N., C.S., B.K.G., B.Z., A.Z., S.S., J.O., R.M.H., B.D., L.B., O.D., G.B.R., P.R., S.D.L.); Epilepsy Center (L.V., N.L., J.P.H., N.J.H., N.S., X.Z., V.R.-M., S.D.L.) and Division of Pulmonary, Critical Care and Sleep Medicine (K.S.), University Hospitals Cleveland Medical Center, OH; University of Iowa School of Medicine (R.K.S., B.K.G., G.B.R.), Iowa City; NYU Langone School of Medicine (D.F., O.D.), New York; Sidney Kimmel Medical College (M.N.), Thomas Jefferson University, Philadelphia, PA; Institute of Neurology (C.S., B.D.), University College London, UK; Feinberg School of Medicine (S.S.), Northwestern University, Chicago, IL; Department of Neurobiology and Brain Research Institute (J.O., R.M.H.), University of California, Los Angeles (UCLA); Department of Neurology (L.B.), Columbia University, New York, NY; and Department of Clinical Neuroscience (P.R.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

Objective: To characterize peri-ictal apnea and postictal asystole in generalized convulsive seizures (GCS) of intractable epilepsy.

Methods: This was a prospective, multicenter epilepsy monitoring study of autonomic and breathing biomarkers of sudden unexpected death in epilepsy (SUDEP) in patients ≥18 years old with intractable epilepsy and monitored GCS. Video-EEG, thoracoabdominal excursions, nasal airflow, capillary oxygen saturation, and ECG were analyzed. Read More

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http://dx.doi.org/10.1212/WNL.0000000000006785DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340388PMC
January 2019
12 Reads

Sudden unexpected death in epilepsy: The neuro-cardio-respiratory connection.

Seizure 2019 Jan 13;64:65-73. Epub 2018 Dec 13.

Athens University School of Medicine, Athens, Greece. Electronic address:

Sudden unexpected death in epilepsy (SUDEP) is the major cause of epilepsy-related premature mortality which targets preferentially younger people. Its etiology remains unknown. Several risk factors have been identified with generalized tonic-clonic seizures as the most important one; seizure control remains the most effective measure of prevention. Read More

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http://dx.doi.org/10.1016/j.seizure.2018.12.007DOI Listing
January 2019
2 Reads

Sudden unexpected death with rare compound heterozygous variants in PRICKLE1.

Neurogenetics 2018 Dec 18. Epub 2018 Dec 18.

Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.

Progressive myoclonus epilepsy-ataxia syndrome (EPM5) is an autosomal recessive form of progressive myoclonus epilepsy that has been associated with a homozygous missense mutation in PRICKLE1. We report a 23-year-old male who died shortly after refractory convulsion and respiratory failure. Autopsy showed unilateral hippocampal malformation without significant neuronal loss or gliosis. Read More

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http://dx.doi.org/10.1007/s10048-018-0562-8DOI Listing
December 2018
1 Read

Late-onset Lennox-Gastaut syndrome: Diagnostic evaluation and outcome.

Neurol Clin Pract 2018 Oct;8(5):397-402

Department of Neurology, Mayo Clinic, Rochester, MN.

Background: We describe the clinical features and outcome in patients with late-onset Lennox-Gastaut syndrome (LGS).

Methods: Adult patients evaluated between January 1, 2000, and March 1, 2017, who presented with onset of LGS ≥10 years were identified. Data abstracted included age at seizure onset, seizure types, etiology, treatments, EEG and neuroimaging results, cerebrospinal fluid (CSF) findings, and autoimmune evaluation. Read More

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http://dx.doi.org/10.1212/CPJ.0000000000000527DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276343PMC
October 2018
1 Read

The effect of generalized seizure activity on ischemia-induced cardiac arrhythmias and myocardial injury with histopathological evaluation in anesthetized rats

Turk J Med Sci 2018 Dec 12;48(6):1293-1301. Epub 2018 Dec 12.

Department of Physiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey

Background/aim: Epileptic seizure leads to sudden unexpected death in epilepsy (SUDEP) among affected patients. The causes of SUDEP are still unclear. The aim of this study was to research the effect of epilepsy on myocardial injury and arrhythmias during experimentally induced acute myocardial ischemia. Read More

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http://dx.doi.org/10.3906/sag-1807-99DOI Listing
December 2018

[Sudden death in epilepsy].

Rev Med Chil 2018 Aug;146(8):902-908

Liga Chilena contra la Epilepsia, Clínica Dávila, Clínica Universidad de los Andes, Santiago, Chile.

The risk of sudden unexpected death in patients with epilepsy (SUDEP), is 20 to 25 times greater than in the general population. This increased risk is seen specially in refractory epilepsy, with an incidence of 9:1,000 patients-years. Risk factors have been established based on retrospective studies, finding that the frequency of seizures, specially generalized tonic clonic seizures, is the most important one. Read More

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http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S
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http://dx.doi.org/10.4067/s0034-98872018000800902DOI Listing
August 2018
3 Reads

What information about sudden unexpected death in epilepsy (SUDEP) is available on YouTube?

Epilepsy Behav 2018 Dec 6. Epub 2018 Dec 6.

Charleston Area Medical Center, Charleston, WV, USA; West Virginia University/Charleston Division, Charleston, WV, USA.

Objective: We sought to assess and analyze the information available about sudden unexpected death in epilepsy (SUDEP) and the general perception of this condition by the public on YouTube.

Methods: We evaluated all consecutive videos containing references to 'sudden unexpected death in epilepsy' and 'SUDEP' on YouTube. Data were extracted after applying the inclusion and exclusion criteria. Read More

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http://dx.doi.org/10.1016/j.yebeh.2018.10.017DOI Listing
December 2018

A systematic review of sudden unexpected death in epilepsy (SUDEP) in childhood.

Epilepsy Behav 2019 Jan 3;90:99-106. Epub 2018 Dec 3.

Population, Policy and Practice Unit, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.

Background: Sudden Unexpected Death in Epilepsy (SUDEP) is a significant cause of death in childhood epilepsy, and causes considerable concern to patients and their families. Despite this, the condition remains poorly understood. This systematic review investigates the risk factors, pathophysiology, and circumstances associated with childhood SUDEP. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15255050183082
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http://dx.doi.org/10.1016/j.yebeh.2018.11.006DOI Listing
January 2019
26 Reads

Altered A-type potassium channel function in the nucleus tractus solitarii in acquired temporal lobe epilepsy.

J Neurophysiol 2019 Jan 5;121(1):177-187. Epub 2018 Dec 5.

Department of Physiology, College of Medicine, University of Kentucky , Lexington, Kentucky.

Sudden unexpected death in epilepsy (SUDEP) is among the leading causes of death in people with epilepsy. Individuals with temporal lobe epilepsy (TLE) have a high risk for SUDEP because the seizures are often medically intractable. Neurons in the nucleus tractus solitarii (NTS) have been implicated in mouse models of SUDEP and play a critical role in modulating cardiorespiratory and autonomic output. Read More

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http://dx.doi.org/10.1152/jn.00556.2018DOI Listing
January 2019
2 Reads

Autonomic aspects of sudden unexpected death in epilepsy (SUDEP).

Clin Auton Res 2018 Nov 19. Epub 2018 Nov 19.

Department of Neurology, Jefferson Comprehensive Epilepsy Center, Sidney Kimmel Medical College at Thomas Jefferson University, 901 Walnut Street, Suite 400, Philadelphia, PA, 19107, USA.

Sudden unexpected death in epilepsy (SUDEP) is a major cause of epilepsy-related mortality. SUDEP is highly linked to seizures, with most deaths occurring after convulsive seizures in sleep. In most cases of SUDEP, convulsive seizures appear to directly trigger catastrophic cardiorespiratory dysfunction leading to death. Read More

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http://link.springer.com/10.1007/s10286-018-0576-1
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http://dx.doi.org/10.1007/s10286-018-0576-1DOI Listing
November 2018
12 Reads

Sudden unexpected death in epilepsy: Risk factors, biomarkers, and prevention.

Acta Neurol Scand 2019 Mar 11;139(3):220-230. Epub 2018 Dec 11.

Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio.

Sudden unexpected death in epilepsy (SUDEP) is one of the most important direct epilepsy-related causes of death, with an incidence in adults of 1.2 per 1000 person-years. Generalized tonic-clonic seizures have consistently emerged as the leading risk factor for SUDEP, particularly when such seizures are uncontrolled. Read More

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http://doi.wiley.com/10.1111/ane.13049
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http://dx.doi.org/10.1111/ane.13049DOI Listing
March 2019
10 Reads

Neuro-Glial Network Model Of Postictal Generalized EEG Suppression (PGES).

Conf Proc IEEE Eng Med Biol Soc 2018 Jul;2018:2044-2047

Over the past couple of decades, glial cells have been highlighted as active agents in hyperexcitability of neuronal networks, specifically playing key roles in seizure onset and termination. In particular, microglia have been suggested to have both neuroprotective and neurotoxic effects on the brain. Investigation into seizure termination is of particular interest, as it is sometimes followed by a postictal generalized EEG suppression (PGES) - a low activity state that is potentially associated with sudden unexpected death in epilepsy. Read More

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http://dx.doi.org/10.1109/EMBC.2018.8512661DOI Listing

Ictal hypoxemia: A systematic review and meta-analysis.

Seizure 2018 Dec 21;63:7-13. Epub 2018 Oct 21.

Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King's College London, UK. Electronic address:

Purpose: To estimate the incidence of ictal hypoxemia (IH) and to identify clinical and study-related factors modulating the estimate.

Methods: We searched articles recording concurrent peri-ictal and ictal EEG and Sp02 in adults and children with epilepsy. Studies reporting the total number of seizures recorded and the number of seizures with IH were included in a random-effects meta-analysis. Read More

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http://dx.doi.org/10.1016/j.seizure.2018.10.011DOI Listing
December 2018
2 Reads

Ictal Asystole in Temporal Lobe Epilepsy: A Possible Cause of Sudden Unexplained Death - A Case Report.

Neurodiagn J 2018 Nov 2:1-5. Epub 2018 Nov 2.

a Department of Neurology University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma.

We report a case of a 47-year-old woman who presented with a 3-year history of paroxysmal events after suffering traumatic brain injury in a motor vehicle accident. She had not previously been diagnosed with epilepsy. On video-EEG monitoring, she was found to have a right temporal seizure associated with ictal asystole lasting for 18 seconds. Read More

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https://www.tandfonline.com/doi/full/10.1080/21646821.2018.1
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http://dx.doi.org/10.1080/21646821.2018.1531671DOI Listing
November 2018
6 Reads

Heart rate variability measurement in epilepsy: How can we move from research to clinical practice?

Epilepsia 2018 Dec 21;59(12):2169-2178. Epub 2018 Oct 21.

Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.

Our objective was to critically evaluate the literature surrounding heart rate variability (HRV) in people with epilepsy and to make recommendations as to how future research could be directed to facilitate and accelerate integration into clinical practice. We reviewed relevant HRV publications including those involving human subjects with seizures. HRV has been studied in patients with epilepsy for more than 30 years and, overall, patients with epilepsy display altered interictal HRV, suggesting a shift in autonomic balance toward sympathetic dominance. Read More

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http://dx.doi.org/10.1111/epi.14587DOI Listing
December 2018

Acid reflux induced laryngospasm as a potential mechanism of sudden death in epilepsy.

Epilepsy Res 2018 12 9;148:23-31. Epub 2018 Oct 9.

Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, US; Department of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, US. Electronic address:

Objective: Recent research suggests that obstructive laryngospasm and consequent respiratory arrest may be a mechanism in sudden unexpected death in epilepsy. We sought to test a new hypothesis that this laryngospasm is caused by seizures driving reflux of stomach acid into the larynx, rather than spontaneous pathological activity in the recurrent laryngeal nerve.

Approach: We used an acute kainic acid model under urethane anesthesia to observe seizure activity in Long-Evans rats. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09201211183032
Publisher Site
http://dx.doi.org/10.1016/j.eplepsyres.2018.10.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276113PMC
December 2018
10 Reads

Deceleration and acceleration capacities of heart rate in patients with drug-resistant epilepsy.

Clin Auton Res 2018 Oct 16. Epub 2018 Oct 16.

National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, 100084, China.

Objective: Epilepsy and seizures can have dramatic effects on cardiac function. The aim of the present study was to investigate deceleration capacity, acceleration capacity and their 24-h fluctuations of heart rate variability in patients with drug-resistant epilepsy.

Methods: Deceleration capacity, acceleration capacity of heart rate and their 24-h dynamics derived from the phase rectified signal averaging method as well as traditional measures were analyzed in 39 patients with drug-resistant epilepsy and 33 healthy control subjects using 24-h electrocardiogram recordings. Read More

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http://link.springer.com/10.1007/s10286-018-0569-0
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http://dx.doi.org/10.1007/s10286-018-0569-0DOI Listing
October 2018
12 Reads
1.864 Impact Factor

Post-ictal Modulation of Baroreflex Sensitivity in Patients With Intractable Epilepsy.

Front Neurol 2018 26;9:793. Epub 2018 Sep 26.

Department of Electrical Engineering and Computer Science, Case School of Engineering, Case Western Reserve University, Cleveland, OH, United States.

Seizure-related autonomic dysregulation occurs in epilepsy patients and may contribute to Sudden Unexpected Death in Epilepsy (SUDEP). We tested how different types of seizures affect baroreflex sensitivity (BRS) and heart rate variability (HRV). We hypothesized that BRS and HRV would be reduced after bilateral convulsive seizures (BCS). Read More

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http://dx.doi.org/10.3389/fneur.2018.00793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6168624PMC
September 2018
2 Reads

Obstructive sleep apnea in refractory epilepsy: A pilot study investigating frequency, clinical features, and association with risk of sudden unexpected death in epilepsy.

Epilepsia 2018 10 24;59(10):1973-1981. Epub 2018 Sep 24.

Mayo Center for Sleep Medicine, Mayo Clinic and Foundation, Rochester, Minnesota.

Objective: We aimed to determine the frequency of probable obstructive sleep apnea (pOSA) in refractory epilepsy monitoring unit inpatients and clinical features associated with pOSA, including risk for sudden unexpected death in epilepsy (SUDEP).

Methods: We prospectively recruited 49 consecutive adult patients admitted to the Mayo Clinic Epilepsy Monitoring Unit with focal, generalized, or unclassified epilepsy syndromes. pOSA was identified using oximetric oxyhemoglobin desaturation index (ODI) and the Sleep Apnea-Sleep Disorders Questionnaire (SA-SDQ) and STOP-BAG screening tools. Read More

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http://dx.doi.org/10.1111/epi.14548DOI Listing
October 2018
2 Reads

Nocturnal supervision and SUDEP risk at different epilepsy care settings.

Neurology 2018 Oct 21;91(16):e1508-e1518. Epub 2018 Sep 21.

From the Stichting Epilepsie Instellingen Nederland (SEIN) (M.v.d.L., J.W.S., R.D.T.), Heemstede; Leiden University Medical Center (LUMC) (M.v.d.L., R.D.T.), Netherlands; GH Sergievsky Center and Department of Epidemiology (D.C.H.), Columbia University, New York, NY; NIHR University College London Hospitals Biomedical Research Centre (J.W.S., R.D.T.), UCL Institute of Neurology, Queen Square, London, and Chalfont Centre for Epilepsy, Chalfont St Peter, UK.

Objective: To estimate the incidence of sudden unexpected death in epilepsy (SUDEP) in people with intellectual disabilities in residential care settings and to ascertain the effects of nocturnal seizures and nocturnal supervision on SUDEP risk.

Methods: We conducted a nested case-control study reviewing records of all people who died at 2 residential care settings over 25 years. Four controls per case were selected from the same population, matched on age (±5 years) and residential unit. Read More

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http://dx.doi.org/10.1212/WNL.0000000000006356DOI Listing
October 2018
6 Reads
8.290 Impact Factor

Sleep-disordered breathing, neuroendocrine function, and clinical SUDEP risk in patients with epilepsy.

Epilepsy Behav 2018 10 31;87:78-82. Epub 2018 Aug 31.

Comprehensive Epilepsy and Sleep Center, Department of Neurology, Columbia University Medical Center New York, NY, United States.

Introduction: Sudden unexpected death in epilepsy (SUDEP) is a major contributor to epilepsy-related mortality. It is associated with nocturnal seizures and centrally mediated postictal cardiorespiratory dysfunction (CRD), but mechanisms and contributors remain poorly understood.

Methods: We performed a prospective, cross-sectional, observational pilot study in the Columbia University Medical Center (CUMC) adult epilepsy monitoring unit (EMU) to explore relationships between periictal CRD, sleep-disordered breathing (SDB), neuroendocrine function, and clinical SUDEP risk. Read More

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http://dx.doi.org/10.1016/j.yebeh.2018.07.011DOI Listing
October 2018
2 Reads

Ictal Mammalian Dive Response: A Likely Cause of Sudden Unexpected Death in Epilepsy.

Authors:
Jose L Vega

Front Neurol 2018 17;9:677. Epub 2018 Aug 17.

Department of Neurosciences and Stroke, Novant Health, Forsyth Medical Center, Winston-Salem, NC, United States.

Even though sudden unexpected death in epilepsy (SUDEP) takes the lives of thousands of otherwise healthy epilepsy patients every year, the physiopathology associated with this condition remains unexplained. This article explores important parallels, which exist between the clinical observations and pathological responses associated with SUDEP, and the pathological responses that can develop when a set of autonomic reflexes known as the mammalian dive response (MDR) is deployed. Mostly unknown to physicians, this evolutionarily conserved physiological response to prolonged apnea economizes oxygen for preferential use by the brain. Read More

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http://dx.doi.org/10.3389/fneur.2018.00677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6108060PMC

From fix to fit into the autoptic human brains.

Eur J Histochem 2018 Aug 27;62(3). Epub 2018 Aug 27.

University of Milan, "Lino Rossi" Research Center for the study and prevention of unexpected perinatal death and SIDS Department of Biomedical, Surgical and Dental Sciences; Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua; Department of Medical Sciences, Section of Pharmacology and National Institute of Neuroscience, University of Ferrara.

Formalin-fixed, paraffinembedded (FFPE) human brain tissues are very often stored in formalin for long time. Formalin fixation reduces immunostaining, and the DNA/RNA extraction from FFPE brain tissue becomes suboptimal. At present, there are different protocols of fixation and several procedures and kits to extract DNA/RNA from paraffin embedding tissue, but a gold standard protocol remains distant. Read More

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https://www.ejh.it/index.php/ejh/article/view/2944
Publisher Site
http://dx.doi.org/10.4081/ejh.2018.2944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6151333PMC
August 2018
12 Reads

Autopsy findings of SUDEP in adolescence.

Authors:
D Afandi I Romus

Malays J Pathol 2018 Aug;40(2):185-189

Universitas Riau, Faculty of Medicine, Forensic Medicine and Medicolegal Studies Department, Jl. Diponegoro 1, Pekanbaru, Riau, Indonesia.

Sudden unexpected death in epilepsy (SUDEP) is a rare in children; the risk of SUDEP in children is up to 10-fold less than adults. Herein, we report a case of SUDEP in a 14-year-old boy. The post-mortem findings in neuropathological examination in SUDEP are not pathognomonic. Read More

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August 2018
14 Reads

Deficient post-ictal cardiorespiratory compensatory mechanisms mediated by the periaqueductal gray may lead to death in a mouse model of SUDEP.

Epilepsy Res 2018 11 19;147:1-8. Epub 2018 Aug 19.

Departments of Pharmacology and Neurology, Southern Illinois University School of Medicine, PO BOX 19629, Springfield, IL, 62794-9629, United States. Electronic address:

Post-ictal cardiorespiratory failure is implicated as a major cause of sudden unexpected death in epilepsy (SUDEP) in patients. The DBA/1 mouse model of SUDEP is abnormally susceptible to fatal seizure-induced cardiorespiratory failure (S-CRF) induced by convulsant drug, hyperthermia, electroshock, and acoustic stimulation. Clinical and pre-clinical studies have implicated periaqueductal gray (PAG) abnormalities in SUDEP. Read More

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http://dx.doi.org/10.1016/j.eplepsyres.2018.08.005DOI Listing
November 2018
20 Reads

The analysis of circadian rhythm of heart rate variability in patients with drug-resistant epilepsy.

Epilepsy Res 2018 10 6;146:151-159. Epub 2018 Aug 6.

National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, 100084, Beijing, China; Man-Machine-Environment Engineering Institute, School of Aerospace Engineering, Tsinghua University, 100084, Beijing, China; Precision Medicine & Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, 518055, Shenzhen, China; Center of Epilepsy, Beijing Institute for Brain Disorders, 100069, Beijing, China. Electronic address:

Objective: The aim of this study was to investigate the variations and the circadian rhythm of multi-domain parameters of heart rate variability (HRV) in patients with drug-resistant epilepsy.

Methods: Time domain HRV parameters of 24-hour data, frequency and non-linear domain HRV parameters were calculated using a 24-hour ambulatory electrocardiogram (ECG) from subjects in a resting and awake state (5-min data from 9:00-10:00 a.m. Read More

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http://dx.doi.org/10.1016/j.eplepsyres.2018.08.002DOI Listing
October 2018
24 Reads
2.020 Impact Factor

Sudden unexpected death in epilepsy, periictal physiology, and the SUDEP-7 Inventory.

Epilepsia 2018 Oct 29;59(10):e157-e160. Epub 2018 Aug 29.

New York Presbyterian Hospital and Columbia University Medical Center, New York, New York.

Sudden unexpected death in epilepsy (SUDEP) is a significant public health burden. Epidemiological studies have identified clinical SUDEP risk factors across large populations, but the means to apply this information to individual patients are lacking. The SUDEP-7 Inventory was developed as a marker of clinical SUDEP risk and has been used in studies of potential SUDEP biomarkers. Read More

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http://dx.doi.org/10.1111/epi.14552DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204287PMC
October 2018
2 Reads

Cortical thinning in epilepsy patients with postictal generalized electroencephalography suppression.

Eur J Neurol 2019 Jan 27;26(1):191-197. Epub 2018 Sep 27.

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Background And Purpose: The aim was to investigate the brain microstructural abnormalities in epilepsy patients with postictal generalized electroencephalographic suppression (PGES) using a cortical surface-based analysis.

Methods: According to the video-electroencephalography records of epilepsy patients with generalized convulsive seizures, 30 patients with PGES (PGES+) and 21 patients without PGES (PGES-) were recruited. High-resolution T1-weighted images were acquired from each patient and 30 matched healthy control subjects. Read More

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http://dx.doi.org/10.1111/ene.13794DOI Listing
January 2019
1 Read

Dead in the water: Epilepsy-related drowning or sudden unexpected death in epilepsy?

Epilepsia 2018 Oct 26;59(10):1966-1972. Epub 2018 Aug 26.

Department of Neurology, New York University, School of Medicine, Epilepsy Center, New York, New York.

Objective: Both drowning and sudden unexpected death in epilepsy (SUDEP) are diagnoses of exclusion with predominantly nonspecific autopsy findings. We hypothesized that people with epilepsy found dead in water with no clear sign of submersion could be misdiagnosed as SUDEP.

Methods: All reported seizure-related deaths undergoing medicolegal investigation in three medical examiner's offices (New York City, Maryland, San Diego County) over different time periods were reviewed to identify epilepsy-related drownings and SUDEPs. Read More

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http://dx.doi.org/10.1111/epi.14546DOI Listing
October 2018
10 Reads