Sudden unexpected death in epilepsy in children: A focused review of incidence and risk factors

ORCID

Abstract

Sudden unexpected death in epilepsy (SUDEP) in children, although rare, needs critical attention given the tragic nature and devastating consequences for families and caregivers. True incidence is unknown and risk factors are not completely understood, more so in children compared with adults. A focused narrative review of available studies on paediatric SUDEP was undertaken to comprehend its risk factors and to develop strategies to recognise and where possible modify SUDEP risk and ultimately reduce incidence. We reviewed 16 population-based studies from various settings. We found overlapping risk factors from different studies. The prime risk factor is uncontrolled seizures. This review supports the view that children entering adolescence with optimal seizure control could be a key aspect in reducing adult mortality related to SUDEP. Ideally, clinicians would want to be able to predict prospective, individualised SUDEP risk, which is challenging due to a myriad of risk factors and an inherent non-homogeneous paediatric epilepsy population. Nevertheless, an adequate evidence base exists as evidenced by this review to support information giving and communication to support young people with epilepsy and their families in being active partners in recognising and reducing their SUDEP risk. More work particularly in the form of prospective studies and registries are needed to further clarify true incidence which may have been previously underestimated and to update risk factors.

DOI

10.1136/jnnp-2017-317702

Publication Date

2018-10-01

Publication Title

Journal of Neurology, Neurosurgery and Psychiatry

Volume

89

Issue

10

ISSN

0022-3050

Embargo Period

9999-12-31

Keywords

epilepsy, non-clinician, paediatric neurology, post mortem, sudden death

First Page

1064

Last Page

1070

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