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Clinical Epileptology

Erschienen in:

15.10.2018 | Epilepsie | Leitthema

Epilepsie, Schlaf und plötzlicher unerwarteter Tod

verfasst von: Max Christian Pensel, PD Dr. med. Rainer Surges, MHBA

Erschienen in: Clinical Epileptology | Ausgabe 1/2019

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Zusammenfassung

Hintergrund

Der plötzliche unerwartete Tod stellt eine seltene, aber schwerwiegende Komplikation für Epilepsiepatienten dar. Das Risiko hierfür ist u. a. nachts und bei Menschen mit nächtlichen Anfällen erhöht, weshalb das Verständnis der Beziehungen zwischen SUDEP („sudden unexpected death in epilepsy“) und Schlaf von hoher Bedeutung ist.

Ziel der Arbeit

Der Artikel stellt die bisher bekannten pathophysiologischen Aspekte und spezifischen Gefahrenpotenziale für SUDEP dar, wobei der Schwerpunkt auf schlafbezogene Zusammenhänge gelegt wird. Darauf aufbauend wird skizziert, welche Präventions- und Gegenmaßnahmen infrage kommen.

Material und Methoden

Aktuelle wissenschaftliche Untersuchungen zu dem Themenkomplex SUDEP und Schlaf werden analysiert und in Form einer narrativen Übersichtsarbeit präsentiert.

Ergebnisse

SUDEP tritt insbesondere bei jungen Erwachsenen und häufiger bei Männern auf. Die meisten dokumentierten SUDEP-Fälle beginnen mit einem nächtlichen epileptischen Anfall, auf den ein neurovegetativer Zusammenbruch mit respiratorischer und kardialer Dekompensation folgt, der von einem flachen EEG begleitet wird.

Diskussion

Eine frühe Wiederherstellung von Atmungs- und Kreislauffunktionen kann im akuten Fall diese potenziell tödliche Kaskade durchbrechen. Eine wirksame Anfallskontrolle durch Antiepileptika, Epilepsiechirurgie oder Neurostimulation zur Vermeidung insbesondere von generalisierten tonisch-klonischen Anfällen stellt das wichtigste präventive Element dar.

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Titel: Epilepsie, Schlaf und plötzlicher unerwarteter Tod
verfasst von: Max Christian Pensel
PD Dr. med. Rainer Surges, MHBA
Publikationsdatum: 15.10.2018
Verlag: Springer Medizin
Schlagwörter: Epilepsie
Epileptischer Anfall
Erschienen in: Clinical Epileptology / Ausgabe 1/2019
Print ISSN: 2948-104X
Elektronische ISSN: 2948-1058
DOI: https://doi.org/10.1007/s10309-018-0225-7

Neu in den Fachgebieten Neurologie und Psychiatrie

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Epilepsie, Schlaf und plötzlicher unerwarteter Tod

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Diskussion

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