ORCID

Abstract

Background: Sudden Unexpected Death in Epilepsy (SUDEP) is a leading cause of mortality among people withepilepsy (PWE). Risk factors such as increased seizure frequency, drug-resistant epilepsy, and early epilepsy onsetare well recognised. However, little evidence of the role of seizure severity, specifically Status Epilepticus (SE) onSUDEP risk exists.Objective: To identify mechanisms, risk factors and clinical characteristics overlap between SE and SUDEP.Methods: A scoping review using the PRISMA-ScR model was performed by two reviewers using suitable searchterms. The PubMed Advanced Search tool along with the ancestry method was utilised to identify suitable articles published between 06/1992 and 05/2023. Quantitative, qualitative and mixed method studies wereincluded. A narrative synthesis was undertaken and is presented as themes and subthemes.Results: Of 5453 papers identified in the preliminary search, 50 studies were suitable for final analysis. Keythemes include overlap between SE complications and SUDEP risk factors (pharmaco-resistant generalised tonicclonic epilepsy, intellectual disability), overlap of shared risk factors (alcohol abuse, developmental epilepticencephalopathies) and clinical characteristics (cardiac and respiratory). SE’s role in development of drug-resistantepilepsy was the strongest potential mechanism for SE’s contribution to SUDEP risk. SE’s contribution torecurrent ictal hypoxaemia episodes and lowered heart rate variability suggests a relationship with SUDEPneeding further study.Conclusions: This review identifies research areas of influence of SE on SUDEP risk. Such research could informcounselling for patients concerned about seizure severity in relation to their SUDEP risk and optimise surveillance and subsequent management of post-SE epileptogenic outcomes.

Publication Date

2024-10-09

Publication Title

Epilepsy and Behavior

Volume

160

ISSN

1525-5050

Acceptance Date

2024-10-03

Deposit Date

2024-10-10

Funding

None. RS has received institutional and research support from LivaNova, UCB, Eisai, Veriton Pharma, Bial, Angelini, UnEEG and Jazz/GW pharma outside the submitted work. He holds grants from NIHR AI, SBRI and other funding bodies all outside this work. No other author has any declared conflict of interest related to this paper. We confirm that we have read the journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. All authors satisfy the ICMJE guidance by substantially contributing to the design, analysis and interpretation of the work, drafting of the manuscript, final approval of the manuscript and all agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work is appropriately investigated and resolved. None. The data that support the findings of this study are available from the corresponding author upon reasonable request.

Keywords

Status Epilepticus, SUDEP, Epilepsy, Risk factor, Mortality

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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