Factors Linked to Risk for Sudden Unexpected Death in Epilepsy Identified
WEDNESDAY, Oct. 1, 2025 -- Factors associated with an increased risk for sudden unexpected death in epilepsy (SUDEP) have been identified, according to a study published online Sept. 17 in The Lancet.
Manuela Ochoa-Urrea, M.D., from the McGovern Medical School at The University of Texas Health Science Center at Houston, and colleagues conducted a multicenter, observational study at nine centers involving children and adults with epilepsy who were undergoing prolonged video electroencephalographic monitoring.
The researchers enrolled 2,632 children and adults with epilepsy between Sept. 17, 2011, and Dec. 30, 2021; 164 participants were lost to follow-up. Overall, 1.54 percent of 2,468 participants died from SUDEP and two had near-SUDEP events. From a cohort of 7,982 person-years, the incident SUDEP mortality rate was 4.76 cases per 1,000 person-years. Significant predictors of SUDEP risk included living alone, three or more generalized convulsive seizures in the previous year, longer ictal central apnea, and longer postictal central apnea (hazard ratios, 7.62, 3.1, 1.11, and 1.32, respectively). Longer ictal central apnea was not significant in a subanalysis excluding possible and near-SUDEP cases.
"This paper for the first time established that you can identify individual patients at risk, and you can actually characterize the risk markers that will identify people at highest risk of death, in order to put mitigative strategies in place to reduce mortality," senior author Samden D. Lhatoo, M.D., also from the McGovern Medical School, said in a statement.
Several authors disclosed ties to the pharmaceutical industry.
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