Why Are Cases of SUDEP Declining?

COMMENTARY

Why Are Cases of SUDEP Declining?

Andrew N. Wilner, MD; Daniel Friedman, MD

Disclosures

September 23, 2020

3

This transcript has been edited for clarity.

Andrew N. Wilner, MD: Welcome to Medscape. I'm Dr Andrew Wilner. Today I have a special guest, Dr Daniel Friedman, professor of neurology at New York University medical school and the author of a paper that caught my eye in the journal Neurology on sudden unexplained death in epilepsy (SUDEP). Welcome, Dr Friedman.

Daniel Friedman, MD: Thank you for having me.

Wilner: SUDEP is something that's been around for a long time. Can you define it for us?

Friedman: SUDEP has been around for a while. In fact, there are even descriptions of SUDEP in George Washington's diary. His niece passed away from what was presumably SUDEP.

SUDEP is not a single entity. It's better described as a phenomenon when a person with epilepsy, who is otherwise in good health apart from their seizures, dies suddenly and unexpectedly and not due to status epilepticus or prolonged seizure.

The causes are thought to be myriad, but most evidence points to the fact that the death occurs soon after a seizure. Most of the evidence we have, which comes from witnessed cases of these deaths, are that SUDEP follows a tonic-clonic seizure.

Wilner: And one idea is, if you want to avoid SUDEP, avoid convulsions?

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