Epilepsy kills

Abstract

Epilepsy is one of the most common serious brain disorders; it knows no age, racial, social class, geographic, or national boundaries 1 . Often epilepsy is still seen as a benign condition in which individuals only have seizures. Unfortunately, the story is not as simple as it seems. Epilepsy is a malignant condition, which has a high rate of premature death compared to the general population [2][3][4] . Most of the excess death is due to the underlying disease causing epilepsy, and some is epilepsy-related, including trauma, suicide, aspiration pneumonia, status epilepticus, but mostly due to sudden unexpected death in epilepsy (SUDEP) that is a leading cause of mortality in epileptics [2][3][4] . The lack of findings in autopsy and the fact that most cases of SUDEP are not witnessed cause difficulties with regard to the definitions of SUDEP. It is generally defined as a sudden, unexpected, witnessed or not witnessed, nontraumatic and non-drowning death in patients with epilepsy, with or without evidence of a seizure and excluding documented status epilepticus, in which postmortem examination does not reveal a toxicological or anatomical cause of death 5 . The reported incidence of SUDEP is quite variable, and this is largely due to differences in patient populations, study design, and the criteria for defining SUDEP 4 . In fact, results from a US population-based study indicate that the risk of sudden death in people with epilepsy is estimated to be at least 20 times higher than the one of the general population 6 . In general terms, SUDEP is responsible for 7.5 to 17% of all deaths in people with epilepsy and it has an incidence among adults between 1:500 and 1:1,000 patient-years 7 . Concerning risk factors, several studies have tried for more than ten years to find factors predisposing to SUDEP in order to identify individuals with particularly high risks. To date, several risk factors have been identified such as refractoriness of the epileptic condition, presence of convulsive seizures, early onset of epilepsy, antiepileptic medication (polytherapy with antiepileptic drugs), young age, and duration of the seizure disorder 4,8,9 . The cause(s) of SUDEP is(are) still unknown, however research consistently suggests that the main mechanism for SUDEP is autonomic deregulation, i.e., cardiac and respiratory abnormalities during and after seizures 4,[8][9][10] . It is clear that SUDEP is mainly, yet not exclusively, a problem for people with uncontrolled epilepsy 9 , but our understanding of the best way to prevent it is still incomplete. Strict evidence for their effectiveness is still lacking, but epidemiological and observational data seem to suggest some measures to minimize the risk of SUDEP, including good seizure control, stress reduction, participation in physical activity and sports (with appropriate professional supervision), dietary management (omega-three supplementation), night supervision, family members' knowledge of cardiopulmonary resuscitation techniques, and the basics of defibrillator use 9,1...

Environmental air pollution is an aggravating event for sudden unexpected death in epilepsy

“…Despite all aforementioned features, the notion persists that epilepsy is a benign condition in which individuals only have seizures. Thus, it is pertinent to mention that epilepsy is a malignant condition that has a high rate of premature death, compared to the death rate in the general population [4][5][6] . By this reasoning, sudden unexpected death in epilepsy (SUDEP) is probably the most common cause of epi lepsy-related deaths 4,5,7 .…”

“…Thus, it is pertinent to mention that epilepsy is a malignant condition that has a high rate of premature death, compared to the death rate in the general population [4][5][6] . By this reasoning, sudden unexpected death in epilepsy (SUDEP) is probably the most common cause of epi lepsy-related deaths 4,5,7 . The term SUDEP is used when sudden death occurs in an otherwise reasonably healthy person with epilepsy and the autopsy examination does not reveal a toxicological or anatomical cause of death 4,8 .…”

Omega-3 intake in people with epilepsy under regular hemodialysis program: here to stay

“…Epilepsy is one of the most prevalent neurological diseases worldwide and mortality rates are considerably higher in those that bear it [3][4][5][6] . Sudden unexpected death in epilepsy (SUDEP) is the main cause of death in people with chronic epilepsy [3][4][5][6] , accounting for 17.0% of them. It has an incidence among epileptic adults between 1:500 and 1:1,000 patient-years 7 .…”

Perfil epidemiológico dos óbitos por epilepsia no Estado do Tocantins entre 2009 e 2019

“…A autora ressalta ainda que a idade, o gênero, o tipo e a duração da CE são alguns fatores de risco para morte precoce de pacientes epilépticos. Scorza (2012) destaca que as principais condições que possuem relação com o óbito por epilepsia são: traumas, suicídio, pneumonia por aspiração e o estado epiléptico. Entretanto, a maior causa de óbitos em pessoas com esta condição é a morte súbita inesperada em epilepsia (SUDEP).…”