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Current Treatment Options in Neurology
Erschienen in: Current Treatment Options in Neurology 10/2018

01.10.2018 | Epilepsy (E Waterhouse, Section Editor)

Reducing the Risk of Sudden Unexpected Death in Epilepsy (SUDEP)

verfasst von: Lance Watkins, MRCPsych, MSc, Rohit Shankar, MBE, FRCPsych

Erschienen in: Current Treatment Options in Neurology | Ausgabe 10/2018

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Abstract

Purpose of Review

Recent reports have highlighted an increase in the number of epilepsy-related deaths. Sudden unexpected death in epilepsy (SUDEP) is thought to be the number one cause of death in chronic epilepsy. This review provides a summary of the current evidence of how to communicate, stratify, and mitigate known risk factors for SUDEP.

Recent Findings

There is now a clearer understanding of the possible pathological mechanisms that contribute to SUDEP. SUDEP is the culmination of multifactorial predisposing and precipitating factors and has been linked to particular candidate genes. A number of static and modifiable risk factors for SUDEP have been consistently identified. Recent guidance has emphasised the importance of communicating SUDEP risk to individuals at the earliest appropriate time.

Summary

SUDEP risk assessment should be integral to the care of individuals with epilepsy. The use of evidence-based risk assessment tools may provide an opportunity to communicate identified risks in a person-centred holistic way. There is increasing evidence to support the use of wearable seizure monitoring devices to help reduce the frequency and impact of convulsive seizures, perhaps the number one risk factor for SUDEP.
Literatur
1.
De Boer HM, Mula M, Sander JW. The global burden and stigma of epilepsy. Epilepsy Behav. 2008;12(4):540–6.CrossRefPubMed
2.
Office for National Statistics Death registrations summary table, England and Wales. 2013
3.
Deaths associated with neurological conditions in England 2001 to 2014 Data analysis report. Public Health England. 2018. This recent publication highlights an alarming trend of increased mortality rates associated with neurological conditions including epilepsy.
4.
5.
Nashef L, So EL, Ryvlin P, Tomson T. Unifying the definitions of sudden unexpected death in epilepsy. Epilepsia. 2012;53(2):227–33.CrossRefPubMed
6.
Hesdorffer DC, Tomson T, Benn E, Sander JW, Nilsson L, Langan Y, et al. Combined analysis of risk factors for SUDEP. Epilepsia. 2011;52(6):1150–9.CrossRefPubMed
7.
•• Tomson T, Surges R, Delamont R, Haywood S, Hesdorffer DC. Who to target in sudden unexpected death in epilepsy prevention and how? Risk factors, biomarkers, and intervention study designs. Epilepsia. 2016;57(S1):4–16. This paper summarises the current evidence on identified SUDEP risk factors.CrossRefPubMed
8.
Surges R, Sander JW. Sudden unexpected death in epilepsy: mechanisms, prevalence, and prevention. Curr Opin Neurol. 2012;25(2):201–7.CrossRefPubMed
9.
Shmuely S, Van der Lende M, Lamberts RJ, Sander JW, Thijs RD. The heart of epilepsy: current views and future concepts. Seizure. 2017;44:176–83.CrossRefPubMed
10.
Devinsky O, Hesdorffer DC, Thurman DJ, Lhatoo S, Richerson G. Sudden unexpected death in epilepsy: epidemiology, mechanisms, and prevention. Lancet Neurol. 2016;15(10):1075–88.CrossRefPubMed
11.
Ryvlin P, Nashef L, Lhatoo SD, Bateman LM, Bird J, Bleasel A, et al. Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. Lancet Neurol. 2013;12(10):966–77.CrossRefPubMed
12.
Goldman AM, Behr ER, Semsarian C, Bagnall RD, Sisodiya S, Cooper PN. Sudden unexpected death in epilepsy genetics: molecular diagnostics and prevention. Epilepsia. 2016;57(S1):17–25.CrossRefPubMedPubMedCentral
13.
Tu E, Bagnall RD, Duflou J, Semsarian C. Post-mortem review and genetic analysis of sudden unexpected death in epilepsy (SUDEP) cases. Brain Pathol. 2011;21(2):201–8.CrossRefPubMed
14.
Bagnall RD, Crompton DE, Petrovski S, Lam L, Cutmore C, Garry SI, et al. Exome-based analysis of cardiac arrhythmia, respiratory control, and epilepsy genes in sudden unexpected death in epilepsy. Ann Neurol. 2016;79(4):522–34.CrossRefPubMed
15.
Hodges MR, Wehner M, Aungst J, Smith JC, Richerson GB. Transgenic mice lacking serotonin neurons have severe apnea and high mortality during development. J Neurosci. 2009;29(33):10341–10,349.CrossRefPubMedPubMedCentral
16.
•• Harden C, Tomson T, Gloss D, Buchhalter J, Cross JH, Donner E, et al. Practice guideline summary: sudden unexpected death in epilepsy incidence rates and risk factors Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2017;88(17):1674–80. Guidance on good practice and communication of risk.CrossRefPubMed
17.
The National Institute for Health and Care Excellence (NICE). The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care. NICE clinical guideline 137. 2012. guidance.nice.org.uk/cg137
18.
Mclean B, Shankar R, et al. SUDEP – measures to reduce risk. Pract Neurol. 2017;17:13–20.CrossRefPubMed
19.
Shankar R, Donner EJ, McLean B, Nashef L, Tomson T. Sudden unexpected death in epilepsy (SUDEP): what every neurologist should know. Epileptic Disord. 2017;19(1):1–9.PubMed
20.
21.
•• Maguire MJ, Jackson CF, Marson AG, Nolan SJ. Treatments for the prevention of sudden unexpected death in epilepsy (SUDEP). Cochrane Database Syst Rev. 2016;7:CD011792. Cochrane review of current SUDEP prevention evidencePubMed
22.
Shankar R, Cox D, Jalihal V, Brown S, Hanna J, McLean B. Sudden unexpected death in epilepsy (SUDEP): development of a safety checklist. Seizure. 2013;22(10):812–7.CrossRefPubMed
23.
•• Shankar R, Walker M, McLean B, Laugharne R, Ferrand F, Hanna J, et al. Steps to prevent SUDEP: the validity of risk factors in the SUDEP and seizure safety checklist: a case control study. J Neurol. 2016;263(9):1840–6. Evidence to support the use of an evidence-based, structured risk assessment tool to communicate risk.CrossRefPubMed
24.
25.
26.
Newman C, Shankar R, Hanna J, McLean B, Osland A, Milligan C, et al. Developing an evidence-based epilepsy risk assessment ehealth solution: from concept to market. JMIR Res Protoc. 2016;5(2):e82.CrossRefPubMedPubMedCentral
27.
DeGiorgio CM, Miller P, Meymandi S, Chin A, Epps J, Gordon S, et al. RMSSD, a measure of vagus-mediated heart rate variability, is associated with risk factors for SUDEP: the SUDEP-7 Inventory. Epilepsy Behav. 2010;19(1):78–81.CrossRefPubMedPubMedCentral
28.
DeGiorgio CM, Markovic D, Mazumder R, Moseley BD. Ranking the leading risk factors for sudden unexpected death in epilepsy. Front Neurol. 2017;8:473.CrossRefPubMedPubMedCentral
29.
30.
Ryvlin P, Cucherat M, Rheims S. Risk of sudden unexpected death in epilepsy in patients given adjunctive antiepileptic treatment for refractory seizures: a meta-analysis of placebo-controlled randomised trials. Lancet Neurol. 2011;10(11):961–8.CrossRefPubMed
31.
Lamberts RJ, Thijs RD, Laffan A, Langan Y, Sander JW. Sudden unexpected death in epilepsy: people with nocturnal seizures may be at highest risk. Epilepsia. 2012;53(2):253–7.CrossRefPubMed
32.
Liebenthal JA, Wu S, Rose S, Ebersole JS, Tao JX. Association of prone position with sudden unexpected death in epilepsy. Neurology. 2015;84(7):703–9.CrossRefPubMed
33.
Shmuely S, Surges R, Sander JW, Thijs RD. Prone sleeping and SUDEP risk: the dynamics of body positions in nonfatal convulsive seizures. Epilepsy Behav. 2016;62:176–9.CrossRefPubMed
34.
Sperling MR, Feldman H, Kinman J, Liporace JD, O’Connor MJ. Seizure control and mortality in epilepsy. Ann Neurol. 1999;46(1):45–50.CrossRefPubMed
35.
Annegers JF, Coan SP, Hauser WA, Leestma J. Epilepsy, vagal nerve stimulation by the NCP system, all-cause mortality, and sudden, unexpected, unexplained death. Epilepsia. 2000;41(5):549–53.CrossRefPubMed
36.
Granbichler CA, Nashef L, Selway R, Polkey CE. Mortality and SUDEP in epilepsy patients treated with vagus nerve stimulation. Epilepsia. 2015;56(2):291–6.CrossRefPubMed
37.
38.
39.
•• Jory C, Shankar R, Coker D, McLean B, Hanna J, Newman C. Safe and sound? A systematic literature review of seizure detection methods for personal use. Seizure. 2016;36:4–15. Systematic review of technology-based seizure detection devices.CrossRefPubMed
40.
Arends J, Van Hoek D, Van Mierlo P, Van Dorp J, Kramer N, Van Der Vorst D, et al. Diagnostic accuracy of audio based seizure detection in patients with severe epilepsy and a mental impairment. Epilepsy Behav. 2016;62:180–5.CrossRefPubMed
41.
Narechania AP, Garić II, Sen-Gupta I, Macken MP, Gerard EE, Schuele SU. Assessment of a quasi-piezoelectric mattress monitor as a detection system for generalized convulsions. Epilepsy Behav. 2013;28(2):172–6.CrossRefPubMed
42.
Poppel KV, Fulton SP, McGregor A, Ellis M, Patters A, Wheless J. Prospective study of the Emfit movement monitor. J Child Neurol. 2013;28(11):1434–6.CrossRefPubMed
43.
Fulton S, Poppel KV, McGregor A, Ellis M, Patters A, Wheless J. Prospective study of 2 bed alarms for detection of nocturnal seizures. J Child Neurol. 2013;28(11):1430–3.CrossRefPubMed
44.
Carlson C, Arnedo V, Cahill M, Devinsky O. Detecting nocturnal convulsions: efficacy of the MP5 monitor. Seizure-European Journal of Epilepsy. 2009;18(3):225–7.CrossRefPubMed
45.
Shankar R, Jory C, Tripp M, Cox D, Hagenow K. Monitoring nocturnal seizure in vulnerable patients. Learn Disabil Pract. 2013;16(9):36.CrossRef
46.
Cuppens K, Chen CW, Wong KBY, Van de Vel A, Lagae L, Ceulemans B, Tuytelaars T, Van Huffel S, Vanrumste B, Aghajan H. Integrating video and accelerometer signals for nocturnal epileptic seizure detection. In Proceedings of the 14th ACM international conference on Multimodal interaction. 2012; (pp. 161–164). ACM.
47.
Lockman J, Fisher RS, Olson DM. Detection of seizure-like movements using a wrist accelerometer. Epilepsy Behav. 2011;20(4):638–41.CrossRefPubMed
48.
Beniczky S, Polster T, Kjaer TW, Hjalgrim H. Detection of generalized tonic–clonic seizures by a wireless wrist accelerometer: a prospective, multicenter study. Epilepsia. 2013:54(4).CrossRefPubMed
49.
Cuppens K, Karsmakers P, Van de Vel A, Bonroy B, Milosevic M, Luca S, et al. Accelerometry-based home monitoring for detection of nocturnal hypermotor seizures based on novelty detection. IEEE J Biomed Health Informatics. 2014;18(3):1026–33.CrossRef
50.
Onorati F, Regalia G, Caborni C, Migliorini M, Bender D, Poh MZ, et al. Multicenter clinical assessment of improved wearable multimodal convulsive seizure detectors. Epilepsia. 2017;58(11):1870–9.CrossRefPubMed
51.
Massé F, Penders J, Serteyn A, van Bussel M, Arends J. Miniaturized wireless ECG-monitor for real-time detection of epileptic seizures. In Wireless Health. 2010; (pp. 111–117). ACM.
52.
Vandecasteele K, De Cooman T, Gu Y, Cleeren E, Claes K, Paesschen WV, et al. Automated epileptic seizure detection based on wearable ECG and PPG in a hospital environment. Sensors. 2017;17(10):2338.CrossRef
53.
54.
Cavazos J, Girouard M, Whitmire L. Novel ambulatory EMG-based GTC seizure detection device for home & hospital use (I6-4B). Neurology. 2015;84(14 Supplement):I6–4B.
55.
Graves J, Arjona J, Gourraud PA. Wearable electromyogram device associated with disability outcomes in adults with multiple sclerosis (P1.377). Neurology. 2017;88(16 Supplement)
56.
Poh MZ, Loddenkemper T, Reinsberger C, Swenson NC, Goyal S, Sabtala MC, Madsen JR, Picard RW. Convulsive seizure detection using a wrist-worn electrodermal activity and accelerometry biosensor. Epilepsia, 2012; 53(5).CrossRefPubMed
57.
Picard RW, Migliorini M, Caborni C, Onorati F, Regalia G, Friedman D, et al. Wrist sensor reveals sympathetic hyperactivity and hypoventilation before probable SUDEP. Neurology. 2017;89(6):633–5.CrossRefPubMed
58.
Ge A, Gonzalez E, Lee SW, Carmenate Y, Collard M, Dixon-Salazar T, Crone N, Krauss G. Seizure triggers in epilepsy patients: a national perspective, American Academy of Neurology 69th Annual Meeting. 2017; (S37. 002).
59.
Hampel KG, Jahanbekam A, Elger CE, Surges R. Seizure-related modulation of systemic arterial blood pressure in focal epilepsy. Epilepsia. 2016;57(10):1709–18.CrossRefPubMed
60.
Hampel KG, Elger CE, Surges R. Impaired baroreflex sensitivity after bilateral convulsive seizures in patients with focal epilepsy. Front Neurol. 2017;8:210.CrossRefPubMedPubMedCentral
61.
Dupuis M, Van Rijckevorsel K, Evrard F, Dubuisson N, Dupuis F, Van Robays P. Takotsubo syndrome (TKS): a possible mechanism of sudden unexplained death in epilepsy (SUDEP). Seizure. 2012;21(1):51–4.CrossRefPubMed
62.
Monté CPJA, Arends JBAM, Tan IY, Aldenkamp AP, Limburg M, De Krom MCTFM. Sudden unexpected death in epilepsy patients: risk factors: a systematic review. Seizure. 2007;16(1):1–7.CrossRefPubMed
63.
Sveinsson O, Andersson T, Carlsson S, Tomson T. The incidence of SUDEP: a nationwide population-based cohort study. Neurology. 2017:10–1212.
64.
Faingold CL, Tupal S, Randall M. Prevention of seizure-induced sudden death in a chronic SUDEP model by semichronic administration of a selective serotonin reuptake inhibitor. Epilepsy Behav. 2011;22(2):186–90.CrossRefPubMed
65.
Watkins L, Shankar R, Sander JW. Identifying and mitigating sudden unexpected death in epilepsy (SUDEP) risk factors. Expert Rev Neurother. 2018;18(4):265–74.CrossRefPubMed
Metadaten
Titel
Reducing the Risk of Sudden Unexpected Death in Epilepsy (SUDEP)
verfasst von
Lance Watkins, MRCPsych, MSc
Rohit Shankar, MBE, FRCPsych
Publikationsdatum
01.10.2018
Verlag
Springer US
Erschienen in
Current Treatment Options in Neurology / Ausgabe 10/2018
Print ISSN: 1092-8480
Elektronische ISSN: 1534-3138
DOI
https://doi.org/10.1007/s11940-018-0527-0

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