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Fatal risks for people with epilepsy: Do you know how common SUDEP is?
People with epilepsy face many risks, one of the most deadly is sudden unexpected death in epilepsy (SUDEP). This is a fatal complication of epilepsy, defined as the sudden and unexpected death of a person with epilepsy without toxic or anatomical causes. Although the physiological mechanism of SUDEP is not fully understood, it may be the main cause of death in epilepsy patients, accounting for 7.5% to 17% of epilepsy-related deaths. For patients with refractory epilepsy, this proportion may be even higher. Up to 50%.
The mechanism of SUDEP may involve multiple factors, including respiratory, cardiac, and brain factors, and epilepsy and the severity of the seizure also play an important role.
Classification of SUDEP
SUDEP classification can be divided into four categories:
- Deterministic SUDEP: Non-traumatic, non-drowning death in a person with epilepsy in the absence of any cause of death.
- Probable SUDEP: Insufficient information or inability to conduct a cause of death determination.
- Probable SUDEP: All criteria for definite SUDEP are met, but no cause of death determination has been performed.
- SUDEP Unlikely: Alternative causes of death are identified that exclude the possibility of SUDEP.
Risk Factors
Many factors may increase your risk of SUDEP, including:
- Frequency and severity of epileptic seizures, particularly the occurrence of generalized tonic-clonic seizures.
- Age: Younger people with epilepsy are at higher risk.
- Gender: Studies show that males are at higher risk.
- Seizures during sleep: Seizures during sleep appear to increase the likelihood of SUDEP.
- Ability to follow medical instructions: Not taking medications or changing treatment plans may also increase risk.
Several genetic mutations have been found to be associated with an increased risk of SUDEP, but the overall understanding of genetic risk is currently incomplete.
Mechanism of SUDEP
The mechanism behind SUDEP is still not fully understood, and it mainly involves the following situations:
- Cardiac factors: Epileptic seizures may trigger heart arrhythmias.
- Respiratory factors: Dyspnea or lung dysfunction caused by the attack.
- Dysregulation of the brain and autonomic nervous system: Changes in brain function after a seizure may affect the heart and respiratory systems.
- Genetic factors: Some gene mutations are known to increase the risk of SUDEP.
Management and Prevention
The most effective strategy for preventing SUDEP is symptom control, but this is often challenging in patients with refractory epilepsy. The following measures may be effective:
- Appropriate medication and lifestyle management to control seizures.
- Use devices that can monitor seizures and help caregivers respond promptly.
- Increase your understanding of epilepsy patients and learn correct first aid measures.
According to data from the United States, approximately 1.16 cases of SUDEP occur in epilepsy patients each year. A survey in Denmark showed that there were 1.9 cases of sudden cardiac death per 100,000 people. In comparison, the sudden death rate among patients with epilepsy is higher.
Studies show that young adults with epilepsy have a 20 to 40 times higher risk of sudden death than the general population.
SUDEP is a serious and often overlooked risk, and it is important to understand how often it occurs and what causes it. As a reader, have you ever thought about how you can help reduce this risk and protect those with epilepsy around you?
