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Muerte súbita inesperada en la epilepsia

SUDEP

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La muerte súbita inesperada ocurre en un pequeño número de personas con epilepsia. Las personas con mayor riesgo son aquellas con convulsiones severas y frecuentes. Prevenir las convulsiones en la medida de lo posible con tratamiento puede reducir el riesgo de muerte súbita. Un grupo de apoyo puede ser útil si ha quedado viudo por la muerte inesperada de un ser querido.

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  • Sudden unexpected death in epilepsy (SUDEP) is when someone with epilepsy dies suddenly and the reason is unknown.

  • The exact cause of SUDEP is not known, but theories include seizures affecting heart or breathing function.

  • SUDEP is rare, causing about 500 deaths per year in the UK.

  • The risk is highest for people with poorly controlled generalised tonic-clonic seizures, especially during sleep.

  • To minimise risk, prevent seizures as much as possible, usually with medication.

Selecciones de videos para Epilepsy and seizures

For more general information about epilepsy and seizures, see the separate leaflets called Epilepsy and Seizures y Types of Epilepsy and Seizures.

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What is sudden unexpected death in epilepsy?

Sudden unexpected death in epilepsy (SUDEP) is a term used when a person with epilepsy suddenly dies and the reason for the death is not known. For example, it is not due to injury or to drowning following or during a seizure and it is not due to a prolonged and severe seizure (status epilepticus).

The cause is not known. If a post-mortem examination is done on a person who dies of SUDEP, no abnormality is found to account for the death. There are various theories as to why a person with epilepsy may die suddenly. One theory is that a seizure may affect a part of the brain that controls heart or breathing function and so the heart and/or breathing just stop during a seizure.

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The risk is small for most people with epilepsy. It is estimated to cause about 500 deaths per year in the UK. This sounds a lot; however, when you compare it to the number of people with epilepsy, it is quite rare. Of those who die from SUDEP, it is most common in people who have generalised tonic-clonic seizures, especially in young adults. The most important risk factors seem to be poor seizure control and seizures occurring during sleep.

Nota: epilepsy is common. About 1 person in 30 in the UK develops epilepsy at some stage. Most people with epilepsy have a normal lifespan and do reportado die of SUDEP.

  • In people with severe epilepsy (frequent and severe tonic-clonic seizures), it is estimated that about 1 in 200 die of SUDEP each year.

  • In people with mild idiopathic epilepsy (epilepsy of unknown cause), it is estimated that about 1 in 1,000 die of SUDEP each year.

  • In people who are in remission, the risk of SUDEP seems to be very low (negligible). The term in remission means that you have had seizures in the past but have none or very few at present. This is either because of treatment or because the epilepsy has settled down.

If you have epilepsy, it may be possible to reduce the small risk of dying from SUDEP by:

  • Preventing seizures as much as possible. This is usually by medication. In some people, surgery is used to prevent seizures when medication has not been successful in preventing seizures. However, in some cases it is not possible to stop seizures fully. See separate leaflet called Treatments for Epilepsy for details.

  • Being aware of the potential risk of night-time seizures. Some people only have seizures at night when asleep (or have them more often at night). As the risk of SUDEP is still present even for night-time seizures, if possible, you should try to prevent these seizures as much as you can. This may mean a review of medication. But again, in some people it is not possible to prevent seizures fully.

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The sudden death of a loved one for any reason (such as due to SUDEP) is very upsetting and traumatic. If you have lost someone close due to this condition, it may be best to talk it through with your GP or with the GP of the affected person. It is a tragic event where usually nothing could have been done to prevent it from happening. Some people find that it helps to get information and help from a support group.

Preguntas frecuentes

What is the key characteristic that defines SUDEP?

SUDEP is defined by a sudden death in someone with epilepsy where no clear cause is found after investigation. This means it is not due to injuries, drowning during a seizure, or a prolonged severe seizure (status epilepticus).

What happens to the body during SUDEP?

When a person dies from SUDEP, a post-mortem examination typically finds no obvious abnormality that explains the death. One theory suggests that a seizure might affect the parts of the brain controlling heart or breathing functions, leading to these vital systems stopping.

Is SUDEP a common cause of death for people with epilepsy?

While about 500 deaths are attributed to SUDEP each year in the UK, the risk for most individuals with epilepsy is considered small. Compared to the total number of people living with epilepsy, it is quite rare, and most people with epilepsy have a normal lifespan.

Are there specific types of seizures that increase the risk of SUDEP?

Yes, SUDEP is most common in individuals who experience generalised tonic-clonic seizures, particularly in young adults. The two main risk factors identified are poor seizure control and seizures that occur during sleep.

Does having epilepsy always mean a higher risk of SUDEP?

Not necessarily. People with severe epilepsy experiencing frequent and severe tonic-clonic seizures have an estimated risk of about 1 in 200 dying of SUDEP each year. However, for those with mild idiopathic epilepsy, the risk is much lower, around 1 in 1,000 annually. For individuals whose epilepsy is in remission (meaning they have few or no seizures), the risk of SUDEP is very low, almost negligible.

What should I do if I am concerned about night-time seizures and SUDEP?

If you experience seizures at night, which can sometimes be more frequent while asleep, it's important to try and prevent these as much as possible. This might involve reviewing your medication. The risk of SUDEP is still present with night-time seizures, although it's understood that sometimes it's not possible to prevent all seizures completely.

Lecturas adicionales y referencias

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Dr Colin Tidy, MRCGP

Médico General, Autor Médico

MBBS, MRCGP, MRCP (Paediatrics), DCH

El Dr. Colin Tidy es un médico del NHS, con sede en Oxfordshire.

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Dr John Cox, MRCGP

MA, MB, B Chir, DCH, DRCOG, MRCP (UK), MRCGP

El Dr. John Cox trabajó como Registrador Médico en el Reino Unido y Nueva Zelanda y como Médico suplente en Nueva Zelanda.

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