Case-control study of SUDEP
Langan Y, Nashef L, and Sander JW (2005) Case-control study of SUDEP. Neurology 64:7 1131–3.
Abstract: OBJECTIVE: To examine the influence of various factors on the risk of sudden unexpected death in epilepsy (SUDEP). METHODS: The authors investigated 154 cases in which a postmortem examination was performed. Each case had four controls with epilepsy from the community, matched for age and geographic location. Backward stepwise conditional logistic regression analysis was performed and odds ratios for risk and protection were determined. RESULTS: The risk of SUDEP was increased with a history of generalized tonic-clonic seizures in the previous 3 months (odds ratio [OR]: 13.8, 95% CI: 6.6 to 29.1). The presence of supervision at night was found to be protective (OR: 0.4, 95% CI: 0.2 to 0.8) when a supervising individual shared the same bedroom or when special precautions such as a listening device were employed (OR: 0.1, 95% CI: 0.0 to 0.3). CONCLUSION: This work lends support to the view that SUDEP is a seizure-related phenomenon and that control of tonic-clonic seizures is important in its prevention. Nocturnal supervision seems to protect against SUDEP.
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Context
- Each of 154 SUDEP victims was matched with 4 controls with epilepsy to identify risk factors. Most patients died in bed and had evidence of recent seizure. GTCS in the previous 3 months was a significant predictive factor, whereas close nighttime supervision appeared to have a protective effect. Polytherapy did not independently increase risk, but use of CBZ did.