Sudden Death in Epilepsy

Though it is one of the most common causes of death in epilepsy patients, SUDEP is still infrequently and even reluctantly named on autopsy reports. This under-reporting equates to a lack of attention and earnest investigation into the cause, predisposition, and prevention of SUDEP. There is as yet little effort to establish an actionable strategy in the mitigation of these potentially fatal arrhythmias. Expanding on the 1990 book Epilepsy and Sudden Death, edited by Lathers and Schraeder, Sudden Death in Epilepsy: Forensic and Clinical Issues reviews of the basic science of epilepsy as it relates to SUDEP. Clinical chapters study the sophisticated simultaneous ambulatory EKG and EEG telemetry and respiratory function monitoring of patients at risk for sudden death that will help identify cardiac, respiratory, and epileptogenic interactions involved. Chapters on animal models evaluate new data from studies that build on previously used models and emphasize that multiple models are needed to investigate the pathophysiology of SUDEP, to hypothesize about effective treatments, to develop pilot studies in persons with epilepsy, and to conduct confirmatory large-scale clinical trials.Contributions discuss the interaction between the central and peripheral autonomic nervous systems and the cardiopulmonary systems; proposed mechanistic factors in SUDEP; risk categories of arrhythmogenic, respiratory, and hypoxia related cardiac death; psychological, emotional, and stress related factors; the role of alcohol and drugs in seizures; and the potential mitigating properties of antiepileptic medication.Adopting a global, multidisciplinary focus to address the mystery of SUDEP, this important work provides clinicians, researchers, patients, and families with the knowledge to freely discuss the phenomenon and thereby discover the preventive treatment regimens to decrease the occurrence of SUDEP.

Forensics of Sudden DeathNeurocardiologic Mechanistic Risk Factors in Sudden Unexpected Death in Epilepsy: C.M. Lathers, P.L. Schraeder, and M.W. BungoForensic Considerations and Sudden Unexpected Death in Epilepsy: J.E. LeestmaOmega-3 Fatty Acids in Sudden Unexpected Death in Epilepsy: Guardian of the Brain–Heart Connection: F.A. Scorza, E.A. Cavalheiro, R.M. Arida, V.C. Terra, C.A. Scorza, E.Y.F. Sonoda and R.M. CysneirosUnanswered Questions: SUDEP Studies Needed: C.M. Lathers, P.L. Schraeder and M.W. BungoMedullary Serotonergic Abnormalities in Sudden Infant Death Syndrome: Implications in SUDEP: D.S. PatersonForensic Case Identification: P.L. Schraeder, E.L. So and C.M. LathersSudden Unexpected Death in Epilepsy: Future Research Directions: S. Parvulescu-CodreaForensic Postmortem Examination of Victims of Sudden Unexpected Death in Epilepsy: C.M. Lathers, P.L. Schraeder, S.A. Koehler and C.H. WechtOne-Year Postmortem Forensic Analysis of Deaths in Persons with Epilepsy: S.A. Koehler, P.L. Schraeder, C.M. Lathers and C.H. WechtDrug Abuse and SUDEP: S.B. KarchCocaine-Induced Seizures, Arrhythmias, and Sudden Death: C.M. Lathers, M.M. Spino, I. Agarwal, L.S.Y. Tyau and W.B. PickworthRisk Factors for Sudden Death in Epilepsy: T. WalczakEEG Findings in SUDEP: M. Nei and N. SimpkinsSeverity of Seizures as a Forensic Risk and Case Reports: E.H. Maa, M.P. Earnest, M.C. Spitz and J. BainbridgeIntractable Epilepsy in the Setting of Malformations of Cortical Development as a Mechanism for SUDEP: L. Jehi and I. NajmNeurogenic Cardiac Arrhythmias: H. Leung and A.Y.Y. ChanStress and SUDEP:C.M. Lathers and P.L. SchraederGenetics of Sudden Death in Epilepsy: N. Ghali and L. NashefCardiac Channelopathies and Sudden Death: B. HerrerosSodium Channel Dysfunction Common Physiopathologic Mechanism Associated with Sudden Death ECG Abnormalities in Brugada Syndrome and Some Types of Epilepsy: Case Histories: C.M. Lathers, P.L. Schraeder and M.W. BungoNot Seizure but Syncope: S. Sharma, T. Ho and B.K. KanthariaSyncope, Seizures, and SUDEP: Case Histories: C.M. Lathers, P.L. Schraeder and M.W. BungoSudden Death in Epilepsy: Relationship to the Sleep–Wake Circadian Cycle and Fractal Physiology: J.D. Hughes and S. SatoSUDEP: Medicolegal and Clinical Experiences: B.B. WannamakerSUDEP Animal ModelsMECHANISMS OF RISKSSudden Death: Animal Models to Study Nervous System Sites of Action for Disease and Pharmacological Intervention: C.M. LathersSynaptic Plasticity of Autonomic Ganglia: Role of Chronic Stress and Implication in Cardiovascular Diseases and Sudden Death: K.A. Alkadhi and K.H. AlzoubiAnimal Model for Sudden Cardiac Death: Autonomic Cardiac Sympathetic Nonuniform Neural Discharge: C.M. LathersAnimal Model for Sudden Unexpected Death in Persons with Epilepsy: C.M. Lathers and P.L. SchraederA Characterization of the Lockstep Phenomenon in Phenobarbital-Pretreated Cats: J.M. Dodd-O and C.M. LathersRelationship of the Lockstep Phenomenon and Precipitous Changes in Blood Pressure: A.Z. Stauffer, J.M. D.O and C.M. LathersInterspike Interval Histogram Characterization of Synchronized Cardiac Sympathetic Neural Discharge and Epileptogenic Activity in the Electrocorticogram of the Cat: D.K. O’Rourke and C.M. LathersPower Spectral Analysis: A Procedure for Assessing Autonomic Activity Related to Risk Factors for Sudden and Unexplained Death in Epilepsy: S.R. Quint, J.A. Messenheimer and M.B. TennisonAnimal Model for Sudden Cardiac Death: Sympathetic Innervation and Myocardial Beta-Receptor Densities: C.M. Lathers and R.M. LevinAntiepileptic Activity of Beta-Blocking Agents: C.M. Lathers, K.F. Jim, W.H. Spivey, C. Kahn, K. Dolce and W.D. MatthewsArrhythmias Associated with Epileptogenic Activity Elicited by Penicillin: C.M. Lathers and P.L. SchraederRole of Neuropeptides in the Production of Epileptogenic Activity and Arrhythmias: C.M. LathersSudden Epileptic Death in Experimental Animal Models: O. Mameli and M.A. CariaSympathetic Nervous System Dysregulation of Cardiac Function and Myocyte Potassium Channel Remodeling in Rodent Seizure Models: Candidate Mechanisms for SUDEP: S.L. Bealer, C.S. Metcalf, J.G. Little, M. Vatta, A. Brewster and A. AndersonThe Urethane/Kainate Seizure Model as a Tool to Explore Physiology and Death Associated with Seizures: M. StewartAcute Cardiovascular Response during Kindled Seizures: J.H. Goodman, R.W. Homan and I.L. CrawfordDBA Mice as Models of Sudden Unexpected Death in Epilepsy: C.L. Faingold, S. Tupal, Y. Mhaskar and V.V. UteshevClinical Issues of Sudden DeathCardiac and Pulmonary Risk Factors and Pathomechanisms of Sudden Unexplained Death in Epilepsy Patients: J. Finsterer and C. StöllbergerNeurocardiac Interactions in Sudden Unexpected Death in Epilepsy: Can Ambulatory Electrocardiogram-Based Assessment of Autonomic Function and T-Wave Alternans Help to Evaluate Risk?: R.L. Verrier and S.C. SchachterArrhythmogenic, Respiratory, and Psychological Risk Factors for Sudden Unexpected Death and Epilepsy: Case Histories: C.M. LathersSudden Arrhythmic Death Syndrome: Underlying Cardiac Etiologies, Their Implications, and the Overlap with SUDEP: P.S. Dhillon and E.R. BehrOdds Ratios Study of Antiepileptic Drugs: A Possible Approach to SUD EP Prevention?: C.M. Lathers, P.L. Schraeder and H.G. ClaycampAntiepileptic Drugs Benefit/Risk Clinical Pharmacology: Possible Role in Cause and/or Prevention of SUDEP: C.M. Lathers and P.L. SchraederClinical Pharmacology and SUDEP: C.M. Lathers and P.L. SchraederExperience-Based Teaching of Therapeutics and Clinical Pharmacology of Antiepileptic Drugs: Sudden Unexplained Death in Epilepsy: Do Antiepileptic Drugs Have a Role?: C.M. Lathers and P.L. SchraederClinical Pharmacology of Antiepileptic Drug Use: Clinical Pearls about the Perils of Patty: P.L. Schraeder and C.M. LathersCompliance with Antiepileptic Drug Treatment and the Risk of Sudden Unexpected Death in Epilepsy: T. TomsonSUDEP Clinical Case Histories: Typical and Atypical: P.L. SchraederCardiac Antiarrhythmic Agents: Pharmacological Basis for their Antiarrhythmic and Proarrhythmic Effects: S. Sharma, T. Ho and B.K. KanthariaCould Beta–Blocker Antiarrhythmic and Antiseizure Activity Help Prevent SUD EP?: C.M. LathersDecision Analysis and Risk Management: H.G. ClaycampEpilepsy Surgery and the Prevention of SUDEP: R.S. Hays and M.R. SperlingChallenges in Overcoming Ethical, Legal, and Communication Barriers in SUDEP: J. Hanna and R. PanelliBereavement and Sudden Unexpected Death in Epilepsy: L. Nashef and L. SahlholdtSUDEP: A Clinical and Communicative Conundrum: P.L. Schraeder and C.M. LathersEpilepsy and SUD EP: Lessons Learned: Scientific and Clinical Experience: C.M. Lathers and P.L. SchraederSUDEP: A Mystery Yet to Be Solved: C.M. Lathers and P.L. SchraederForensic Evidence and Expert Witnesses: Scientific Evidence: Getting It In and Keeping It Out: T.L. BohanIndex