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4 September 2013

Research offers new clues to epilepsy deaths

Research published in Lancet Neurology today (Sept 4) provides new clues to the puzzle of Sudden Unexpected Death in Epilepsy (SUDEP), according to leading neurologist Professor Ley Sander.

Commenting on the research, Professor Sander, medical director, Epilepsy Society said:  'The research sheds light on some of the unknowns that surround SUDEP  and identifies some clear risk factors, which, if acted on, could lead to  a decrease in the number of such tragic events.'

There are around 600 SUDEP deaths each year in the UK  - and every death due to SUDEP is thought to be avoidable. A major reason for the lack of knowledge is that SUDEP is  almost always an unwitnessed event.

In Lancet Neurology Philippe Ryvlin and co authors looked at worldwide incidences of SUDEP in epilepsy monitoring units.
Although epilepsy deaths are extremely rare during monitoring, the cardio respiratory  data available for ten cases of SUDEP in  epilepsy monitoring units showed previously unrecognised patterns of  severe alterations to breathing  and cardiac functions  induced by a generalised tonic clonic seizure leading to death.

Epilepsy monitoring units

The research also  highlighted lessons to be learned for the management of epilepsy monitoring units.
Professor Sander said:  'Epilepsy monitoring units should be a safe environment - but there are indicators from this research for how monitoring units should operate more safely in the future.

'Almost all the deaths occurred during night shifts when nursing cover tends to be sub optimum. The role of anti-epileptic drug reduction as a risk factor for SUDEP also stood out in these findings. A clear lesson here is that any monitoring unit engaging in drug withdrawal needs to have robust cover and contingency for CPR in place.

'A change in breathing patterns was seen in almost all cases of SUDEP, strongly suggesting  that the routine use of oximetry based alarm systems should be mandatory. This change, allied to clear CPR procedures, could reduce the risk of SUDEP in epilepsy monitoring units.'

Read the Lancet Neurology research

 

Read about Epilepsy Society's SUDEP research