Age and SUDEP

Q: Older patients have a higher risk for Sudden unexpected death in epilepsy (SUDEP)?

A) True

B) False

Answer: B

Sudden unexpected death in epilepsy (SUDEP) has a specific definition: "The sudden, unexpected, witnessed or unwitnessed, nontraumatic, and non-drowning death in patients with epilepsy with or without evidence of a seizure, and excluding documented status epilepticus ≥30 minutes in duration, in which post mortem examination does not reveal a structural or toxicologic cause for death".

Interestingly, young patients between 18 and 40 years of age are at highest risk. It is rarely reported in older patients. Reason for this high prevalence in young patients is not known.

#neurology

References:

1. Nashef L, So EL, Ryvlin P, Tomson T. Unifying the definitions of sudden unexpected death in epilepsy. Epilepsia 2012; 53:227. 

2. Hughes JR. A review of sudden unexpected death in epilepsy: prediction of patients at risk. Epilepsy Behav 2009; 14:280. 

3. Harden C, Tomson T, Gloss D, 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; 88:1674. 

4. Hitiris N, Suratman S, Kelly K, et al. Sudden unexpected death in epilepsy: a search for risk factors. Epilepsy Behav 2007; 10:138.