Abstract
The risk of sudden unexpected death in patients with epilepsy (SUDEP), is 20 to 25 times greater than in the general population. This increased risk is seen specially in refractory epilepsy, with an incidence of 9:1,000 patients-years. Risk factors have been established based on retrospective studies, finding that the frequency of seizures, specially generalized tonic clonic seizures, is the most important one. The physiopathological mechanism of SUDEP is not yet fully understood. Autonomic system abnormalities, as well as cardiac and respiratory changes have been found. The finding of new molecular biomarkers to identify patients with increased risk should be a priority. Treatment is based in the management of risk factors, although clear recommendations are hard to establish given the low level of evidence.
Highlights
The risk of sudden unexpected death in patients with epilepsy (SUDEP), is 20 to 25 times greater than in the general population
Risk factors have been established based on retrospective studies, finding that the frequency of seizures, specially generalized tonic clonic seizures, is the most important one
Treatment is based in the management of risk factors, clear recommendations are hard to establish given the low level of evidence. (Rev Med Chile 2018; 146: 902-908) Key words: Death, sudden; Epilepsy; Seizures
Summary
The risk of sudden unexpected death in patients with epilepsy (SUDEP), is 20 to 25 times greater than in the general population. El concepto de muerte súbita en epilepsia, SUDEP por sus siglas en inglés (Sudden Unexpected Death in Epilepsy), se define como la muerte que se produce de forma súbita, inesperada, no traumática ni por asfixia en pacientes con epilepsia, sin considerar como relevante la presencia de testigos, o la evidencia de crisis epiléptica previa, pero se excluyen las muertes secundarias a estatus epiléptico[1]. Entre las causas de muerte más importantes se encuentra SUDEP con 2-18% de los casos, otras causas como estatus epiléptico, accidentes y suicidio, han demostrado tener una prevalencia menor en estudios de países desarrollados[8,9].
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