The sudden unexplained death syndrome in epilepsy: demographic, clinical, and postmortem features.

摘要: Sudden unexplained death syndrome (SUDS) accounts for about 10% of deaths in patients with epilepsy. It is associated subtherapeutic postmortem serum antiepileptic drug (AED) levels but no anatomic cause on autopsy. The mechanisms are not known. We investigated 44 cases SUDS details seizure history, treatment, medical and psychological events at the time death, findings. Cases status epilepticus, drowning or other identifiable causes were excluded. Two groups emerged: five children uncontrolled seizures receiving multiple AEDs good compliance medications, 39 adults less frequent seizures, often monotherapy, noncompliant medications. Four (80%) only one adult (3%) had fully therapeutic AED levels. Sixty-three percent recently experienced an unusually stressful life event. Investigation circumstances suggested two possible modes death: (a) a immediately fatal arrhythmia, or, (b) seizure, recovery, then delayed secondary respiratory arrest arrhythmia. Even though unknown, risk may be reduced by encouraging to compliant especially times unusual stress.