A clinical and pathological study in patients with sudden unexpected death in Epilepsy

• Main Authors: Weihua Yu, Ying Zhu, Qingshu Li, Xin Tian, Peng Zhang, Yang Lü
• Format: Article
• Language: English
• Published: BMC 2019-11-01
• Series: Acta Epileptologica
• Subjects: Epilepsy; Sudden death; Antiepileptic drugs; Risk factors; Sleep asphyxia; Emotional disturbance
• Online Access: http://link.springer.com/article/10.1186/s42494-019-0007-5

Abstract Background Sudden unexpected death of epilepsy (SUDEP) is a severe outcome of epilepsy. This study aimed to report the clinical and pathological findings in patients with SUDEP. Methods The record of patients with sudden death was screened. When the reason of death matched with the definition of SUDEP, the clinical and pathological data were analyzed. Eleven patients with SUDEP were included in the study. Results Eight patients died after a generalized tonic-clonic seizure, seizures were induced by emotional changes in five patients, four cases were found dead in bed. Carbamazepine was prescribed in six patients. The autopsy showed brain edema and pulmonary edema in all eleven patients. Loss of neurons and gliosis were presented in some brains of SUDEP subjects. The main pathological changes in SUDEP include brain edema, pulmonary edema, loss of neurons and gliosis. Conclusions Risk factors for SUDEP in the study are generalized tonic-clonic seizure, emotional disturbance and carbamazepine treatment.