#AimForZero Risks from Seizures and SUDEP

#AimForZero
CONTENT HIGHLIGHTS
  • The American Academy of Neurology (AAN) and American Epilepsy Society (AES) released a new practice guideline on SUDEP.
  • Several studies suggest that the addition of effective anti-seizure medications or epilepsy surgery lowers SUDEP risk.
  • It is also likely that other interventions (such as devices or dietary therapy) that can reduce the frequency of seizures could reduce SUDEP risk.
  • Talk with your health care team now about your risks for seizures and SUDEP. Then work together to create a seizure management and lifestyle plan that's right for you.
Raising Awareness During National Epilepsy Awareness Month
Wednesday, November 1, 2017

At this time, there are no specific therapies – drugs, devices, or other treatments – that have been shown to prevent sudden unexpected death in epilepsy (SUDEP). Many, but not all, witnessed SUDEP occur following a seizure when disturbances in breathing and heart function can be fatal.

AAN/AES SUDEP Guideline for Professionals

In April 2017, the American Academy of Neurology (AAN) and American Epilepsy Society (AES) released a new practice guideline on SUDEP to address two clinical questions:

  1. What are the rates of SUDEP in children and adults with epilepsy?
  2. What are the risk factors for SUDEP?

In preparing the guideline, the authors reviewed 22 high quality studies on SUDEP risk factors and determined that:

  • Having poorly controlled seizures, especially frequent generalized tonic-clonic seizures, is the single greatest risk factor for SUDEP. Having good seizure-control, especially being seizure-free, is associated with a low risk of SUDEP.
  • Nocturnal supervision or use of a nocturnal listening and alerting device can reduce SUDEP risk.
  • There is insufficient evidence on the independent influence of other proposed risk factors, such as nocturnal seizures, duration of epilepsy, number of anti-seizure medications, male sex, or specific drugs.

The guide also provides recommendations to neurologists about how to talk about SUDEP risks with their patients and families. Learn more about the guideline and what it means for you.

Control Seizures, Reduce SUDEP Risk

While there is a lack of direct studies demonstrating that improving seizure control leads to fewer SUDEPs, several studies suggest that the addition of effective anti-seizure medications or epilepsy surgery lowers SUDEP risk. These interventions presumably prevent SUDEP by reducing the frequency and severity of seizures.

Therefore, it is also likely that other interventions that can reduce the frequency of seizures, including neurostimulation devices like the vagus nerve stimulator (VNS) or the responsive neurostimulator system (RNS) or dietary therapies such as the ketogenic or modified Atkins diet, could reduce SUDEP risk by improving seizure control though direct evidence is lacking.

At this time, the best strategy for reducing SUDEP risk is achieving the best seizure control possible.

Talk about SUDEP

Talk with your health care team now about your risks for seizures and SUDEP. Then work together to create a seizure management and lifestyle plan that's right for you.

#AimForZero

Authored by: Daniel Friedman MD | SUDEP Editor on 11/2017
Reviewed by: Joseph I. Sirven MD | Editor-in-Chief on 11/2017

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The mission of the Epilepsy Foundation is to lead the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures, and save lives.

 
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