Update on Sudden Unexpected Death in Epilepsy

Persons with epilepsy (PWE) have an up to 34-fold increased risk of dying suddenly and unexpectedly compared with the general population. Despite being potentially preventable by optimal care, sudden unexpected death in epilepsy (SUDEP) is one of the most frequent causes of death in PWE, especially in children and younger adults. The incidence of SUDEP in the general epilepsy population is rather consistent at 1.2 to 1.3 per 1000 person-year across series. Several risk factors for SUDEP have been identified, but with focal-to-bilateral or generalized tonic-clonic seizures and sleeping alone as the most significant. Thereby, optimal care and nocturnal surveillance might decrease the risk of SUDEP. Finally, PWE wants information about SUDEP, and providing this information might increase adherence to the treatment and thereby good seizure control. This narrative review provides an update on SUDEP.