Sudden unexpected death in patients with epilepsy: Definition, epidemiology and therapeutic implications

CNS Drugs

Volumn 13, Issue 5, 2000, Pages 337-349

  Langan, Yvonne ^a,b   Sander, Josemir W A S ^a  

^a UNIVERSITY COLLEGE LONDON   (United Kingdom)

^b JAMES COOK UNIVERSITY HOSPITAL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ANTICONVULSIVE AGENT;

AUTOPSY; EPILEPSY; HUMAN; INCIDENCE; PRIORITY JOURNAL; REVIEW; RISK ASSESSMENT; SUDDEN DEATH;

EID: 0034095202     PISSN: 11727047     EISSN: None     Source Type: Journal    
DOI: 10.2165/00023210-200013050-00004     Document Type: Review

References (98)

1. 1. Zielinski JJ. Epilepsy and mortality rule and cause of death. Epilepsia 1974; 15 (2): 191-201
2. 2. Cockerell OC, Johnson AL, Sander JW, et al. Mortality from epilepsy: results from a prospective population-based study. Lancet 1994; 344 (8927): 918-21
3. 3. Nilsson L, Tomson T, Farahmand BY, et al. Cause-specific mortality in epilepsy: a cohort study of more than 9,000 patients once hospitalized for epilepsy. Epilepsia 1997; 38: 1062-8
4. 4. Delasiauve M. Terminaisons. In: Masson V, editor. Paris: Traite De L'Epilepsie, 1854: 165-73
5. 5. Bacon GM. On the modes of death in epilepsy. Lancet 1868; 1: 1155-6
6. 6. Geysen MH. De la mort inopinee ou rapide chez les epileptiques [thesis]. Faulte de Medicin et de Pharmacie de Lyon, 1895 (Serie 1, no. 1114)
7. 7. Gowers WR. Prognosis. In: Epilepsy and other chronic convulsive disease: their cause, symptoms and treatment. New York (NY): Dover Publications, 1885: 199-200
8. 8. Spratling WP. The cause and manner of death in epilepsy. Med News 1902; Jun 28: 1225-7
9. 9. Munson JF. Death in Epilepsy. Med Rec 1910; 77: 58-62
10. 10. O'Donoghue MF, Sander JWAS. A historical perspective on the mortality associated with chronic epilepsy. Acta Neurol Scand 1997; 96: 138-41
11. 11. Nashef L. Sudden unexpected death in epilepsy: terminology and Definitions. Epilepsia 1997; 38 Suppl. 11: S6-8
12. 12. Klenerman P, Sander JW, Shorvon SD. Mortality in patients with epilepsy: a study of patients in long term residential care. J Neurol Neurosurg Psychiatry 1993; 56 (2): 149-52
13. 13. Leestma JE, Walczak T, Hughes JR, et al. A prospective study on sudden unexpected death in epilepsy. Ann Neurol 1989; 26 (2): 195-203
14. 14. Earnest MP, Thomas GE, Eden RA, et al. The sudden unexplained death syndrome in epilepsy: demographic, clinical, and postmortem features. Epilepsia 1992; 33 (2): 310-6
15. 15. Brown SW, Mawer GE, Lawler W, et al. Sudden death and epilepsy [letter]. Lancet 1990; 335 (8689): 606-7
16. 16. Nashef L, Garner S, Sander JWAS, et al. Circumstances of death in sudden death in epilepsy: interviews of bereaved relatives. J Neurol Neurosurg Psychiatry 1998; 64: 349-52
17. 17. Leestma JE, Annegers JF, Brodie MJ, et al. Sudden unexplained death in epilepsy: observations from a large clinical development program. Epilepsia 1997; 38 (1): 47-55
18. 18. Tennis P, Cole TB, Annegers JF, et al. Cohort study of incidence of sudden unexplained death in persons with seizure disorder treated with antiepileptic drugs in Saskatchewan, Canada. Epilepsia 1995; 36 (1): 29-36
19. 19. Jick SS, Cole TB, Mesher MD, et al. Sudden unexplained death in young persons with primary epilepsy. Pharmacoepidemiol Drug Saf 1992; 1: 59-64
20. 20. Terrence Jr CE, Wisotzkey HM, Perper JA. Unexpected, unexplained death in epileptic patients. Neurology 1975; 25 (6): 594-8
21. 21. Leestma JE, Kalelkar MB, Teas SS, et al. Sudden unexpected death associated with seizures: analysis of 66 cases. Epilepsia 1984; 25: 84-8
22. 22. Langan Y, Nolan N, Hutchinson M. The incidence of sudden unexpected death in epilepsy in south Dublin and Wicklow. Seizure 1998; 7: 355-8
23. 23. Ficker DM, So EL, Shen WK, et al. Population-based study of the incidence of sudden unexplained death in epilepsy. Neurology 1998; 51: 1270-4
24. 24. Derby LE, Tennis P, Jick H. Sudden unexplained death among subjects with refractory epilepsy. Epilepsia 1996; 37 (10): 931-5
25. 25. Medical Research Council. Randomised study of antiepileptic drug withdrawal in patients in remission. Lancet 1991; 337: 1175-80
26. 26. Kirby S, Sadler RM. Injury and death as a result of seizures. Epilepsia 1995; 36 (1): 25-8
27. 27. Nashef L, Fish DR, Sander JW, et al. Incidence of sudden unexpected death in an adult outpatient cohort with epilepsy at a tertiary referral centre. J Neurol Neurosurg Psychiatry 1995; 58 (4): 462-4
28. 28. Lip GY, Brodie MJ. Sudden death in epilepsy: an avoidable outcome? J R Soc Med 1992; 85 (10): 609-11
29. 29. Timmings PL. Sudden unexpected death in epilepsy: a local audit. Seizure 1993; 2 (4): 287-90
30. 30. Nashef L, Fish DR, Garner S, et al. Sudden death in epilepsy: a study of incidence in a young cohort with epilepsy and learning difficulty. Epilepsia 1995; 36 (12): 1187-94
31. 31. Vickery BG. Mortality in a consecutive cohort of 248 Adolescents who underwent diagnostic evaluation for epilepsy surgery. Epilepsia 1997; 38 Suppl. 11: S67-9
32. 32. Sperling MR, O'Connor MJ, Saykin AJ, et al. Temporal lobectomy for refractory epilepsy. JAMA 1996; 276: 470-5
33. 33. Sperling MR, Feldman H, Kinman J, et al. Seizure control and mortality in epilepsy. Ann Neurol 1999; 46 (1): 45-50
34. 34. Dasheiff RM. Sudden unexpected death in epilepsy: a series from an epilepsy surgery program and speculation on the relationship to sudden cardiac death. J Clin Neurophysiol 1991; 8 (2): 216-22
35. 35. Hennessy MJ, Langan Y, Elwes RDC, et al. A study of mortality after temporal lobe epilepsy surgery. Neurology, 1999; 53 (6): 1276-83
36. 36. Prescribing information for Neurontin (gabapentin), Parke-Davis. In: Physicians desktop reference. 49th ed. Montvale (NJ): Medical Economics Company, 1995: 1856-9
37. 37. Leppik IE. Tiagabine: the safety landscape. Epilepsia 1996; 36: S10-3
38. 38. Annegers JF, Coan SP, Hauser WA, et al. Epilepsy, vagal nerve stimulation by the NCP system, mortality, and sudden, unexpected, unexplained death. Epilepsia 1998; 39: 206-12
39. 39. Harvey AS, Nolan T, Carlin JB. Community-based study of mortality in children with epilepsy. Epilepsia 1993; 34 (4): 597-603
40. 40. Brorson LO, Wranne L. Long-term prognosis in childhood epilepsy: survival and seizure prognosis. Epilepsia 1987; 28 (4): 324-30
41. 41. Sillanpaa M. Children with epilepsy as adults: outcome after 30 years of follow-up. Acta Paediatr Scand Suppl 1990; 368: 1-78
42. 42. Luhdorf K, Jensen LK, Plesner AM. Epilepsy in the elderly: life expectancy and causes of death. Acta Neurol Scand 1987; 76 (3): 183-90
43. 43. Elveback LR, Connolly DC, Kurland LT. Coronary heart disease in residents of Rochester, Minnesota. II. Mortality, incidence and survivorship, 1950-1975. Mayo Clin Proc 1981; 56: 665-72
44. 44. Neuspiel DR, Kuller LH. Sudden and unexpected natural death in childhood and adolescence. JAMA 1985; 254: 1321-5
45. 45. Hauser WA, Annegers JF, Kurland LT. Prevalence of epilepsy in Rochester, Minnesota: 1940-1980. Epilepsia 1991; 32: 429-45
46. 46. Bennani FK, Connolly CE. Sudden unexpected death in young adults including four cases of SADS: a 10 year review from the West of Ireland. Med Sci Law 1997; 372: 42-7
47. 47. Annegers JF, Hauser WA, Shirts SB. Heart disease mortality and morbidity in patients with epilepsy. Epilepsia 1984; 25 (6): 699-704
48. 48. Nilsson L, Farahmand BY, Persson P, et al. Risk factors for sudden unexpected death in epilepsy: a case control study. Lancet 1999; 353: 888-93
49. 49. Kloster R, Engelskjon T. Sudden unexpected death in epilepsy (SUDEP): a clinical perspective and search for risk factors. J Neurol Neurosurg Psychiatry 1999; 67 (4): 439-44
50. 50. Boesen F, Andersen EB, Kehn E, et al. Cardiac conduction disturbances during carbamazepine therapy. Acta Neurol Scand 1983; 68: 49-52
51. 51. Stone S, Lange LS. Syncope and sudden unexpected death attributed to carbamazepine in a 20-year-old epileptic. J Neurol Neurosurg Psychiatry 1986; 49: 1460-1
52. 52. Tomson T, Kenneback G. Arrhythmia, heart rate variability and antiepileptic drugs. Epilepsia 1997; 38 Suppl. 11: S48-51
53. 53. Timmings PL. Sudden unexpected death in epilepsy: is carbamazepine implicated? Seizure 1998; 7: 289-91
54. 54. Opeskin K, Burke MP, Cordner SM, et al. Comparison of antiepileptic drugs in sudden unexpected deaths in epilepsy with deaths from other causes. Epilepsia 1999; 40 (12): 1795-8
55. 55. Kloster R, Borresen HC, Hoff Olsen P. Sudden death in two patients with epilepsy and the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Seizure 1998; 7: 419-20
56. 56. George JR, Davis GG. Comparison of anti-epileptic drug levels in different cases of sudden death. J Forensic Sci 1998; 43: 598-603
57. 57. Tomson T, Skold A, Holmgen P, et al. Postmortem changes in blood concentrations of phenytoin and carbamazepine: an experimental study. Ther Drug Monit 1998; 20: 309-12
58. 58. Jusic N, Lader M. Post-mortem antipsychotic drug concentrations and unexplained deaths. Br J Psychiatry 1994; 165: 787-91
59. 59. Mehtonen OP, Aranko K, Malkonen L, et al. A survey of sudden death associated with the use of antipsychotic or antidepressant drugs: 49 cases in Finland. Acta Psychiatr Scand 1991; 84: 58-64
60. 60. Hirsch CS, Martin DL. Unexpected death in young epileptics. Neurology 1971; 21 (7): 682-90
61. 61. Gastaut H, Gastaut Y. Etude electrocliniques des syncopes posttraumatiques. Rev Neurol 1957; 964: 23-5
62. 62. Bruton CJ. Mortality in epilepsy [letter; comment]. Lancet 1994; 344 (8936): 1579
63. 63. Schwender LA, Troncoso JC. Evaluation of sudden death in epilepsy. Am J Forensic Med Pathol 1986; 7 (4): 283-7
64. 64. Natelson BH, Suarez RV, Terrence CF, et al. Patients with epilepsy who die suddenly have cardiac disease. Arch Neurol 1998; 55: 857-60
65. 65. Langan Y, Sander JWAS. Patients with epilepsy who die do not always have cardiac disease [letter; comment]. Arch Neurol 1999; 56 (2): 249
66. 66. Blumhardt LD, Smith PEM, Owen L. Electrocardiographic accompaniments of temporal lobe epileptic seizures. Lancet 1986; 1: 1051-6
67. 67. Howell SJ, Blumhardt LD. Cardiac asystole associated with epileptic seizures: a case report with simultaneous EEG and ECG. J Neurol Neurosurg Psychiatry 1989; 52 (6): 795-8
68. 68. Dasheiff RM, Dickinson LJ. Sudden unexpected death of epileptic patient due to cardiac arrhythmia after seizure. Arch Neurol 1986; 43 (2): 194-6
69. 69. Fincham RW, Shivapour ET, Leis AA, et al. Ictal bradycardia with syncope: a case report. Neurology 1992; 42: 2222-3
70. 70. Jallon P. Epilepsie et coeur. Rev Neurol 1997; 153: 173-84
71. 71. Katz R, Tiger M, Harner R. Epileptic cardiac arrhythmia: sinoatrial arrest in two patients: a potential cause of sudden death in epilepsy. Epilepsia 1983; 24: 248
72. 72. Phizackerley PJR, Poole WE, Whitty CWM. Sinoauricular block as an epileptic manifestation. Epilepsia 1954; 3: 89-91
73. 73. Nashef L, Walker F, Allen P, et al. Apnoea and bradycardia during epileptic seizures: relation to sudden death in epilepsy. J Neurol Neurosurg Psychiatry 1996; 60 (3): 297-300
74. 74. Tiagaran S, Rasmussen V, Dam M, et al. ECG changes in epilepsy patients. Acta Neurol Scand 1997; 96: 72-5
75. 75. Tavernor SJ, Brown SW, Tavernor RME, et al. Electrocardiograph QT lengthening associated with epileptiform EEG discharges - a role in sudden unexplained death in epilepsy? Seizure 1996; 1: 79-83
76. 76. Schott GD, McLeod AA, Jewitt DE. Cardiac arrhythmias that masquerade as epilepsy. Br Med J 1977; 1 (6074): 1454-7
77. 77. Rogers WJ, Epstein AE, Arciniegas JG, et al. Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. New Engl J Med 1989; 321: 406-12
78. 78. Barron SA. Cardiac arrhythmias after small iv dose of phenytoin [letter]. N Engl J Med 1976; 295 (12): 678
79. 79. Gellerman GL, Martinez C. Fatal ventricular fibrillation following intravenous sodium diphenylhydantoin therapy. JAMA 1967; 200 (4): 337-8
80. 80. Durelli L, Mutani R, Sechi GP, et al. Cardiac side effects of phenytoin and carbamazepine. A dose-related phenomenon? Arch Neurol 1985; 42: 1067-8
81. 81. Knilans TK, Pollack P, Weig SG. Carbamazepine-induced atrioventricular block in a child with tuberous sclerosis and cardiac rhabdomyoma. Ann Neurol 1994: 804-5
82. 82. Dahlqvist L, Henning R, Widell H, et al. Supraventrikular takykardi utlost av karbamazepin [Supraventricular tachycardia caused by carbamazepine?]. Lakartidningen 1977; 74 (5): 337-8
83. 83. Kenneback G, Bergfeldt L, Vallin H, et al. Electrophysiologic effects and clinical hazards of carbamazepine treatment for neurologic disorders in patients with abnormalities of the cardiac conduction system. Am Heart J 1991; 121: 1421-9
84. 84. Kenneback G, Bergfeldt L, Tomson T. Electrophysiological evaluation of the sodium-channel blocker carbamazepine in healthy human subjects. Cardiovasc Drugs Ther 1995; 9: 709-14
85. 85. Kenneback G, Bergfeldt L, Tomson T, et al. Carbamazepine induced bradycardia - a problem in general or only in susceptible patients? A 24-h long-term electrocardiogram study. Epilepsy Res 1992; 13: 141-5
86. 86. Matteoli S, Trappolini M, Curione M, et al. Effetti della carbamazepina sull'eccitoconduzione cardiaca in soggetti giovani: studio seriato con ecg-dinamico [Cardiac conduction during carbamazepine treatment in young patients: an investigation with ambulatory ECG]. G Ital Cardiol 1994; 24: 391-7
87. 87. Kenneback G, Ericson M, Tomson T, et al. Changes in arrhythmia profile and heart rate variability during abrupt withdrawal of antiepileptic drugs. Implications for sudden death. Seizure 1997; 6: 369-75
88. 88. De Silvey DL, Moss AJ. Primidone in the treatment of the long QT syndrome: QT shortening and ventricular arrhythmia suppression. Ann Intern Med 1980; 93: 53-4
89. 89. Schraeder PL, Lathers CM. Paroxysmal autonomic dysfunction, epileptogenic activity and sudden death. Epilepsy Res 1989; 3: 55-62
90. 90. Massetani R, Strata G, Galli R, et al. Alteration of cardiac function in patients with temporal lobe epilepsy: different roles of EEG-ECG monitoring and spectral analysis of RR variability. Epilepsia 1997; 3: 363-9
91. 91. Frysinger RC, Engel J, Harper RM. Interictal heart rate patterns in partial seizure disorders. Neurology 1993; 43: 2136-9
92. 92. Devinsky O, Perrine K, Theodore WH. Interictal autonomic nervous system function in patients with epilepsy. Epilepsia 1994; 35: 199-204
93. 93. Quint SR, Messenheimer JA, Tennison MB. Power spectral analysis: a procedure for assessing autonomic activity related to risk factors for sudden and unexplained death in epilepsy. In: Lathers CM, Schraeder PL, editors. Epilepsy and sudden death. New York (NY): Marcel Dekker, 1990: 261-91
94. 94. Tomson T, Ericson M, Ihrman C, et al. Heart rate variability in patients with epilepsy. Epilepsy Res 1998; 30: 77-83
95. 95. Ramabadran K, Bansinath M. Endogenous opioid peptides and epilepsy. Int J Clin Pharmacol Ther Toxicol 1990; 28: 47-62
96. 96. Johnston SC, Horn JK, Valente J, et al. The role of hypoventilation in a sheep model of epileptic sudden death. Ann Neurol 1995; 37 (4): 531-7
97. 97. Johnston SC, Darragh TM, Simon RP. Postictal pulmonary edema requires pulmonary vascular pressure increases. Epilepsia 1996; 37: 428-32
98. 98. Johnston SC, Seidenberg R, Min JK, et al. Central apnea and acute cardiac ischaemia in a sheep model of epileptic sudden death. Ann Neurol 1997; 42: 588-94