An animal model for SUDEP: The questions shape the answers
Scorza FA, Arida RM, Terra VC, and Cavalheiro EA (2009) An animal model for SUDEP: The questions shape the answers. Epilepsy Behav p. 540.
First Paragraph: Individuals with epilepsy are at higher risk of death than the general population, and sudden unexpected death in epilepsy (SUDEP) is the most important, direct, epilepsy-related cause of death. SUDEP is responsible for 7.5–17% of all deaths in epilepsy and has an incidence among adults of between 1:500 and 1:1000 patient-years. As SUDEP can tragically cut short a young person’s life, several controlled studies have attempted to identify clinical characteristics of patients with epilepsy at particular risk for SUDEP. Thus, the majority of these studies have identified mainly higher risk factors linked to refractoriness of the epilepsy, presence of generalized tonic–clonic seizures, polytherapy with antiepileptic drugs, young age, duration of the seizure disorder ranging from 15 to 20 years, and early onset of epilepsy. Additionally, potential pathomechanisms for SUDEP are unknown, but it is very probable that cardiac arrhythmia (due to myocardial ischemia), electrolyte disturbances, arrhythmogenic drugs or transmission of the epileptic activity via the autonomic nervous system to the heart, and central or obstructive apnea play a potential role.