Sudden unexpected, unexplained death in epilepsy autopsied patients

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Antoniuk SA, Oliva LV, Bruck I, Malucelli M, Yabumoto S, and Castellano JL (2001) Sudden unexpected, unexplained death in epilepsy autopsied patients. Arq Neuropsiquiatr 59:1 40–5

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Abstract: Sudden unexpected, unexplained death in epilepsy (SUDEP) has been reported to be responsible for 2 to 17% of all deaths in patients with epilepsy. This study was conducted to determine the circumstances of SUDEP and the autopsy findings in these patients. Fifty-three individuals whose cause of death was related to epilepsy were identified and in 30 cases relatives or friends were interviewed about the circumstances of death and other information which allowed to classify the patients as SUDEP or not. The death certificates were also reviewed. We found 20 cases of SUDEP. Most of them were found dead lying on the bed with no evidence of seizure event, and most of them had pulmonary and/or cerebral edema as the cause of death. The incidence and the risk of SUDEP can only be fully ascertained if all sudden deaths had postmortem examination. Consensus in certifying SUDEP cases would allow better accuracy in national mortality rate.

Keywords: sudden death, epilepsy, circumstances of death, pulmonary edema


  • Retrospective evaluation from Brazil of cause of death from 9.5 year period with 15,000 patients yielded 53 patients with epilepsy. In 30 cases those close to the deceased were interviewed (“verbal autopsy,” Lathers and Schraeder). The interviews of loved ones came after delays of many years from the time of death in some cases, which may have affected the accuracy of recollections. 20 cases met criteria for SUDEP in this study. Most of these were deaths in bed without evidence of seizure, with pulmonary or cerebral edema listed as the official cause of death. The race distribution of SUDEP deaths matched that of the overall population of deaths evaluated. 45% of patients had a history of excessive use of alcohol.