Talk:Sudden unexpected death in epilepsy/Archive 1

NEJM

doi:10.1056/NEJMra1010481 - thorough review. JFW | T@lk 23:02, 12 November 2011 (UTC)

Merge Suggestion

I intend to do some work on this article in the next few days in terms of updating medrefs and general editing. To that end I also propose the merging of Ictal asystole which is a one sentence stub to this article. Opinions and help are very welcome. Ochiwar (talk) 17:04, 15 March 2014 (UTC)

Withdrawing proposal to merge. The available references indicate that both articles should be developed independently. Ochiwar (talk) 17:01, 18 March 2014 (UTC)

More current research (April 2015)

This entry doesn't seem to have kept up with the latest research. I just read this in Science, for example. They give 3,000 deaths a year in the US. The Lancet Neurology article is pretty important.

http://news.sciencemag.org/biology/2015/04/sudden-death-epilepsy-researchers-finger-possible-cause
Sudden death in epilepsy: Researchers finger possible cause
By Jennifer Couzin-Frankel
8 April 2015
(Sudden unexpected death in epilepsy (SUDEP) could result from a brain stem shutdown following a seizure, researchers report in Science Translational Medicine.)
People with epilepsy are found dead, often following a seizure, sohttps://en.wikipedia.org/w/index.php?title=Talk:Sudden_unexpected_death_in_epilepsy&action=submit#editformmetimes face down in bed. Many are young—the median age is 20—and patients with uncontrolled generalized seizures, the most severe type, are at highest risk. (3,000 deaths/year in US.)
(2013 study of SUDEP in hospital monitoring unit. 10 cases, heart and breathing data, cardiorespiratory systems collapsed over several minutes, brain activity severely depressed. EEG flat after seizure. Gene associated with sudden cardiac death predisposed humans to epilepsy, mice to epilepsy and SUDEP. Human K channel and Na channel mutations, disrupts neuron firing, linked to SUDEP, Na mutation can cause Dravet syndrome, high SUDEP risk. 9/18 mice had spreading depolarization in brain stem, a shutdown of electrical activity that sweeps across the brain region and silences neurons. Usually happens in non-fatal parts of the brain, Aura in migraine. But fatal in tissue that controls breathing and heart function. Without mutations, seizures didn't cause spreading depolarization in mice. Some migraine drugs and antidepressants might inhibit spreading depolarization. Patients with high risk of SUDEP could be identified, possibly those with difficulty breathing or erratic heart rate during seizure.

http://stm.sciencemag.org/content/7/282/282ra46.abstract
Sci Transl Med 8 April 2015. 7(282):282ra46
DOI: 10.1126/scitranslmed.aaa4050
Research Article
Epilepsy: Spreading depolarization in the brainstem mediates sudden cardiorespiratory arrest in mouse SUDEP models
Isamu Aiba and Jeffrey L. Noebels

http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2813%2970214-X/abstract
Lancet Neurology 12(10):966–977, October 2013
DOI: http://dx.doi.org/10.1016/S1474-4422(13)70214-X
Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study
Philippe Ryvlin, Lina Nashef, Samden D Lhatoo, et al.
Background: Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in people with chronic refractory epilepsy. Very rarely, SUDEP occurs in epilepsy monitoring units, providing highly informative data for its still elusive pathophysiology. The MORTEMUS study expanded these data through comprehensive evaluation of cardiorespiratory arrests encountered in epilepsy monitoring units worldwide.
Interpretation: SUDEP in epilepsy monitoring units primarily follows an early postictal, centrally mediated, severe alteration of respiratory and cardiac function induced by generalised tonic-clonic seizure, leading to immediate death or a short period of partly restored cardiorespiratory function followed by terminal apnoea then cardiac arrest. Improved supervision is warranted in epilepsy monitoring units, in particular during night time.
There are also a lot of external links to organizational sites that many not comply with the Wikipedia external links policy. --Nbauman (talk) 03:21, 11 April 2015 (UTC)