Review
Behavioral Sciences
Marina Trivisano, Lorenzo Muccioli, Alessandro Ferretti, Hsiu-Fen Lee, Ching-Shiang Chi, Francesca Bisulli
Summary: The risk of sudden unexpected death in epilepsy (SUDEP) in children is influenced by various factors, including the severity and treatment of epilepsy. Factors such as seizure frequency, type, especially nocturnal generalized tonic-clonic seizures (GTCS), and resistance to anti-seizure medication can predispose patients to SUDEP. SUDEP may be caused by respiratory, cardiovascular, and central autonomic dysfunctions. Genetic mutations in cardiac channelopathy genes may increase the risk of seizure-induced arrhythmias. Night-time supervision can reduce the risk of SUDEP. Reconsidering safety protocols and using seizure detection devices can help reduce the risk of death in epilepsy patients.
EPILEPSY & BEHAVIOR
(2022)
Article
Clinical Neurology
William Szurhaj, Alexandre Leclancher, Anca Nica, Bertille Perin, Philippe Derambure, Philippe Convers, Laure Mazzola, Bertrand Godet, Marie Faucanie, Marie-Christine Picot, Julien De jonckheere
Summary: The study found that patients who died of sudden unexpected death in epilepsy (SUDEP) had an abnormal cardiac autonomic response to sympathetic stimulation through hyperventilation, while the control group showed no significant changes.
Article
Clinical Neurology
Julie Bourgeois-Vionnet, Julien Jung, Romain Bouet, Mathilde Leclercq, Helene Catenoix, Laurent Bezin, Philippe Ryvlin, Sylvain Rheims
Summary: The study found that coffee consumption may be a protective factor for seizure-related respiratory dysfunction, with a dose-dependent effect.
Article
Clinical Neurology
Michael Tan, Samuel S. Allemann, Xiwen Simon Qin, Wendyl J. D'Souza
Summary: This study aims to estimate antiseizure medication adherence using prescription dispensations and identify adherence patterns that influence epilepsy mortality. The findings show that declining adherence is associated with an increased risk of sudden unexpected death, highlighting the importance of maintaining and improving medication adherence to reduce this risk.
Article
Clinical Neurology
Zhe Sage Chen, Aaron Hsieh, Guanghao Sun, Gregory K. Bergey, Samuel F. Berkovic, Piero Perucca, Wendyl D'Souza, Christopher J. Elder, Pue Farooque, Emily L. Johnson, Sarah Barnard, Russell Nightscales, Patrick Kwan, Brian Moseley, Terence J. O'Brien, Shobi Sivathamboo, Juliana Laze, Daniel Friedman, Orrin Devinsky
Summary: SUDEP is the leading cause of epilepsy-related mortality, and currently there are few validated methods to predict individual SUDEP risk. Machine learning-driven models using interictal EEG and ECG recordings can quantify SUDEP risk for epilepsy patients.
FRONTIERS IN NEUROLOGY
(2022)
Article
Clinical Neurology
Margherita Contento, Bruno Bertaccini, Martina Biggi, Matteo Magliani, Ylenia Failli, Eleonora Rosati, Luca Massacesi, Marco Paganini
Summary: Discontinuation of antiepileptic drugs in seizure-free patients may lead to seizure recurrence, especially in those with a seizure-free period on therapy of less than 2 years. Most patients who relapsed could achieve pharmacological control of epilepsy, but the previously described prediction tool showed low accuracy in this cohort.
Review
Clinical Neurology
Michael Lucchesi, Joshua B. Silverman, Krishnamurthi Sundaram, Richard Kollmar, Mark Stewart
Summary: SUDEP is the leading cause of death in young adults with uncontrolled seizures, and evidence suggests a consistent sequence of events that starts with sudden airway occlusion. Enhancing seizure first aid through early oxygen administration and prompt CPR can help prevent death in potential SUDEP cases by recognizing airway occlusion and the need for resuscitation.
FRONTIERS IN NEUROLOGY
(2021)
Article
Clinical Neurology
Chris Serrand, Sylvain Rheims, Marie Faucanie, Arielle Crespel, Vera Dinkelacker, William Szurhaj, Arnaud Biraben, Fabrice Bartolomei, Nathalie de Grissac, Elizabeth Landre, Marie Denuelle, Laurent Vercueil, Cecile Marchal, Louis Maillard, Philippe Derambure, Sophie Dupont, Vincent Navarro, Thibault Mura, Audrey Jaussent, Valerie Macioce, Philippe Ryvlin, Marie-Christine Picot
Summary: A case-control study was conducted to identify risk factors for sudden unexpected death in epilepsy (SUDEP) and develop a risk score for prevention. The study found that generalized and nocturnal seizures increased the risk of SUDEP, while the ability to alert someone of an oncoming seizure was protective. The developed SUDEP-CARE score showed good discrimination capabilities and will require external validation.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Sofia Schierbeck, Jacob Hollenberg, Anette Nord, Leif Svensson, Per Nordberg, Mattias Ringh, Sune Forsberg, Peter Lundgren, Christer Axelsson, Andreas Claesson
Summary: This study aimed to investigate the feasibility of delivering AEDs by drones in real-life cases of OHCA. The results showed that the AED delivery success rate was 92%, with 64% of cases where drones arrived before ambulances, resulting in a median time benefit of 01:52 minutes. However, further improvements are needed to increase dispatch rate and time benefits.
EUROPEAN HEART JOURNAL
(2022)
Article
Clinical Neurology
Manuela Ochoa-Urrea, Nuria Lacuey, Laura Vilella, Liang Zhu, Shirin Jamal-Omidi, M. R. Sandhya Rani, Johnson P. Hampson, Mojtaba Dayyani, Jaison Hampson, Norma J. Hupp, Shiqiang Tao, Rup K. Sainju, Daniel Friedman, Maromi Nei, Catherine Scott, Luke Allen, Brian K. Gehlbach, Victoria Reick-Mitrisin, Stephan Schuele, Jennifer Ogren, Ronald M. Harper, Beate Diehl, Lisa M. Bateman, Orrin Devinsky, George B. Richerson, Guo-Qiang Zhang, Samden D. Lhatoo
Summary: Research on patients with seizure clusters shows that seizure features vary from one seizure to another, with some improving while others deteriorating. The occurrence of SUDEP may have a stochastic nature, where seizure clusters may not necessarily directly contribute to SUDEP.
FRONTIERS IN NEUROLOGY
(2021)
Article
Behavioral Sciences
Kyle C. Rossi, Jonathan M. Gursky, Trudy D. Pang, Mandip S. Dhamoon
Summary: The study found a significant association between epilepsy and status epilepticus events and increased odds of subsequent cardiac arrhythmia or cardiac arrest over multiple chronic timeframes. Enhanced cardiac surveillance may be necessary to reduce morbidity and mortality in patients with epilepsy.
EPILEPSY & BEHAVIOR
(2021)
Review
Clinical Neurology
Xiaxin Yang, Xue Yang, Baopeng Liu, Anqi Sun, Xiuhe Zhao
Summary: This study aimed to investigate the clinical determinants for the occurrence of postictal generalized EEG suppression (PGES) after generalized convulsive seizures (GCS). The results showed that longer tonic phase duration, GCS onset during sleep, older age of epilepsy onset, postictal immobility, and lower oxygen desaturation nadir were significantly associated with the likelihood of having PGES in GCS. However, total seizure duration, tonic-clonic duration, clonic phase duration, epilepsy duration, and lack of early oxygen administration were not significantly associated with PGES occurrence.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2022)
Article
Clinical Neurology
Ashwani Jha, Cheongeun Oh, Dale Hesdorffer, Beate Diehl, Sasha Devore, Martin J. Brodie, Torbjoern Tomson, Josemir W. Sander, Thaddeus S. Walczak, Orrin Devinsky
Summary: The study developed and validated a tool for individualized prediction of SUDEP risk using Bayesian logistic regression model, which showed superior cross-validated personalized predictions compared to baseline models. This tool can enable risk-based stratification for biomarker discovery and interventional trials.
Article
Behavioral Sciences
Jennifer Thorpe, Samantha Ashby, Asma Hallab, Ding Ding, Maria Andraus, Patricia Dugan, Piero Perucca, Daniel Costello, Jacqueline A. French, Terence J. O'Brien, Chantal Depondt, Danielle M. Andrade, Robin Sengupta, Norman Delanty, Nathalie Jette, Charles R. Newton, Martin J. Brodie, Orrin Devinsky, J. Helen Cross, Josemir W. Sander, Jane Hanna, Arjune Sen
Summary: The COVID-19 pandemic has adversely affected the health and well-being of people with epilepsy, increasing the risk of seizures, associated comorbidities, and mortality. Findings from the survey suggest that some individuals with epilepsy experienced health changes during the pandemic, coupled with challenges in accessing services and risk communication inadequacies.
EPILEPSY & BEHAVIOR
(2021)
Article
Clinical Neurology
Kelly G. Knupp, Ingrid E. Scheffer, Berten Ceulemans, Joseph E. Sullivan, Katherine C. Nickels, Lieven Lagae, Renzo Guerrini, Sameer M. Zuberi, Rima Nabbout, Kate Riney, Svetlana Shore, Anupam Agarwal, Michael Lock, Gail M. Farfel, Bradley S. Galer, Arnold R. Gammaitoni, Ronald Davis, Antonio Gil-Nagel
Summary: The trial demonstrates the efficacy of fenfluramine in reducing drop seizures in patients with Lennox-Gastaut syndrome (LGS) and suggests that it may be particularly beneficial for those experiencing generalized tonic-clonic seizures.
