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What is
"SUDEP"?
SUDEP is: Sudden Unexplained Death in Epilepsy
It is an generally defined as a
"uncommon and non-traumatic death that occurs suddenly and unexpectedly in patient
with epilepsy who was otherwise previously healthy".
It is without any obvious clinical or pathological explanations; in many
cases, the patients are found lying in bed (as if they have just stopped breathing during sleep) or on the floor with no evidence of a seizure having occurred. For this reason, it is VERY IMPORTANT that this be kept
in mind anytime who was "previously healthy" dies.
How Common Is It?
SUDEP account for 10% of all epilepsy-related deaths; 85%
of these fatalities occur between the ages of 20-50 years.
The incidence of SUDEP stands at approximately 1 in 1000 people with
epilepsy per year which is at least 10 times of the
sudden death rate found in the general population.
What that means is that, if you have a diagnosis of
epilepsy, you are TEN TIMES more likely to have "Sudden Death".
What Are the Suspected Causes?:
Possiblities include:
An irreversible cardiac arrest (heart attack); according to
one theory, electrical discharges in the brain may change the electrical status of the
heart, affecting its rhythm.( SUDEP have been witnessed in the hospital and Emergency
Department where doctors on the scene were unable to resuscitate the patient.)
Respiratory arrest
(breathing stopped) by a seizure which is generally described as a generalized tonic-clonic convulsion
What
are the Risk Factors of SUDEP?
- People
with refractory (uncontrolled or poorly controlled) epilepsy
- People
with severe epilepsy and learning difficulties
- Young
patients with a long history of generalized tonic-clonic seizures
- Having
at least a 2-year history of epilepsy
- People
who take 2 or more anti-epileptic drugs (especially if combined with psychiatric agents)
- Poor
compliance with anti-epileptic medications (Autopsies reveal that, at the time of death,
50% of affected patients had blood concentrations either below therapeutic levels or in
completely undetectable amounts.)
- Alcohol
abuse (definite links found)
- Alone
during seizure
Can Any Precautionary
Measures Prevent SUDEP?
- Controlling
seizures seems to be the most important thing, however, a very few people have not
survived
their very FIRST seizure so PREVENTION is important.
- Keep
appointments so your doctor can monitor any changes, and adjust your medications
accordingly.
- Take
medications for seizures regularly
- Avoid
sudden drug withdrawal, or dosage changes
- Adopt a
healthy lifestyle:
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Maintain regular and adequate sleep patterns
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Exercise regularly
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Eat regular, nutritious meals
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Learn to cope with stress
- Avoid
alcohol and street drugs
- Always
stay with company so that someone can help during seizure
- Nocturnal
Seizures - Seizures occuring during sleep have a higher incidence of SUDEP.
Preventive
measures might include having the bed near the floor, changing from a feather to a
solid
foam pillow (which may reduce the possibility of suffocation), and having a monitor to
alert
others
in the home when a seizure occurs.
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