SUDEP: Risk factors and prevention

People with epilepsy are at greater risk of early die than the general population. Epilepsy related causes of death in this population account for ۴۰% of the deaths. SUDEP is among the major cause of epilepsy related death after status epilepticus. SUDEP is standing for the sudden, unexpected, witnessed or unwitnessed, non-traumatic and non-drowning death in patients with epilepsy, with or without evidence for a seizure, and excluding documented status epilepticus, in which postmortem examination does not reveal a toxicological or anatomical cause for death. Generalized tonic-clonic seizures are the greatest risk factor for SUDEP; most often, SUDEP occurs after this type of seizure in bed during sleep hours and the person is found in a prone position. Certainly, there are other risk factors including early age onset of epilepsy and male sex, living alone and etc. The exact pathophysiology of SUDEP is currently unknown, although GTCS-induced cardiac, respiratory, and brainstem dysfunction appears likely. Appropriately chosen antiepileptic drug treatment can render around ۷۰% of patients free of all seizures. However, around one-third will remain drug-resistant despite polytherapy. Continuing seizures place patients at risk of SUDEP and reduced quality of life. According to the current data, the best way to prevent SUDEP, is optimizing the control of the seizure by medical or surgical options, educate the patients and care givers and physicians.In this review, we will discuss about the definition, incidence and importance of SUDEP. We will also try to review some of proposed and possible mechanisms that suggested to explain SUDEP so far. At the end we will review some of the SUDEP’s preventive measures.