Excess mortality and sudden unexpected death in epilepsy

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Ryvlin P, Tomson T, and Montavont A (2009) Excess mortality and sudden unexpected death in epilepsy. Presse Med 38:6 905–10.

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Abstract: Patients with epilepsy have a two to three fold increased risk of death as compared to the age-matched general population. This increased risk of death primarily affects young adults with drug resistant epilepsy. Sudden unexpected death in epilepsy (SUDEP) is one of the main cause of mortality in that population, and appears to be the direct consequence of a seizure. The pathophysiology of SUDEP remains unclear, but a post-ictal central or obstructive apnea seems to represent the most likely mechanism. The risk of SUDEP is increased in patients with nocturnal seizures, generalized tonic-clonic seizures, and poor compliance. This risk can be decreased by nocturnal supervision. There is yet no consensus regarding the information about SUDEP that should be delivered to patients with epilepsy, but it seems reasonable to individualize this information according to each patient form of epilepsy.



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