Circumstances Surrounding Sudden Unexpected Death in Epilepsy in Children: A National Case Series
Featuring the work of Elizabeth Donner, CURE Epilepsy grantee. Article published in Epilepsia.
The largest pediatric case series on sudden unexpected death in epilepsy (SUDEP) to date was undertaken by Dr. Elizabeth Donner and colleagues to identify clinical factors that may be associated with SUDEP in childhood.
Pediatric SUDEP cases were studied, including data on demographics, epilepsy history, comorbidities, and circumstances surrounding death. Forty-nine pediatric SUDEP cases were analyzed. The study found that the median age at death was 8 years. Twenty-two had tonic–clonic seizures within the last six months prior to death, while seven children had no tonic–clonic seizures in their lifetime. Two-thirds of children were treated with ≥2 antiseizure medications, and most had genetic etiologies. Similar to adult cohorts, death was often unwitnessed.
SUDEP occurred in children of all ages, including infants, with a spectrum of epilepsies with and without neurodevelopmental impairment. Seventeen children had a recent infection, which could decrease seizure threshold and trigger a terminal seizure. Times of increased seizure risk could warrant heightened surveillance for SUDEP. However, further research is needed to determine the significance of this finding.