SUDEP in the Netherlands: A retrospective study in a tertiary referral center

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Vlooswijk MCG, Majoie HJM, De Krom MCTFM, Tan IY, and Aldenkamp AP (2007) SUDEP in the Netherlands: A retrospective study in a tertiary referral center. Seizure 16:2 153–9.

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Abstract: OBJECTIVE: To evaluate risk factors for sudden and unexpected death in epilepsy (SUDEP) in a high-risk population, i.e. patients treated in a Dutch tertiary referral center for epilepsy. METHODS: All patients who died between January 1999 and April 2004 while under treatment of the epilepsy center were identified. Based on clinical data, deaths were classified as definite, probable, possible or non-SUDEP. Potential risk factors were compared in SUDEP cases and non-SUDEP cases. RESULTS: SUDEP incidence was 1.24 per 1000 patient years. SUDEP patients died at a younger age than patients from the control group of non-SUDEP deaths with epilepsy and had an earlier onset of epilepsy. However, the frequently mentioned factors in previous studies, i.e. male sex, generalized tonic-clonic seizures, high seizure frequency, specific AEDs, polytherapy with several AEDs, mental retardation, psychiatric illness and psychotropic comedication, were not found to be correlated with SUDEP. CONCLUSIONS: Even in this high-risk population of patients with refractory epilepsy, treated in a tertiary referral center, SUDEP is not a frequently occurring phenomenon. Specific risk factors could not be identified within an already high-risk population.

Keywords: SUDEP; Risk factor; Epilepsy; Sudden death

Context

  • Retrospective study over 5 years in a tertiary center. The authors found an incidence of 1.24 per 1,000 patient-years. There was a history of earlier onset of epilepsy among SUDEP cases as compared to non-SUDEP deaths. Evidence did not support a role for GTCS, polytherapy, specific AEDs, or mental retardation.

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