Gaining perspective on SUDEP: The new guideline

Epilepsy is one of the most common neurologic disorders, affecting people of all ages and backgrounds. It is often burdensome, even when seizures are controlled: patients generally require daily costly medications with adverse effects and have higher rates of depression, anxiety, and cognitive disturbances. While there are many available treatments, about one-third of patients continue to have seizures, which imposes greater burdens by restricting the ability to drive, creating underemployment or unemployment, decreasing fertility and marriage rates, lowering quality of life, and causing higher morbidity. In addition, people with uncontrolled epilepsy have increased mortality, with the highest risk from sudden unexpected death in epilepsy (SUDEP), which preferentially targets young people.1 Growing concern about this devastating outcome is reflected in increasing publications devoted to understanding and preventing SUDEP, and calls for action to inform patients about SUDEP.2 Many risk factors have been reported but not substantiated, leading to an overestimation of individual risk. Further, conflicting reports of increased SUDEP incidence in patients taking common medications such as lamotrigine,3 or while in a placebo arm of a drug trial,4 or with low drug levels, leads to much confusion. It is in this context that the American Academy of Neurology (AAN) and the American Epilepsy Society joined to create a guideline to define incidence of SUDEP in children and adults as well...
Source: Neurology - Category: Neurology Authors: Tags: All Pediatric, Incidence studies, Risk factors in epidemiology, All Epilepsy/Seizures EDITORIALS Source Type: research