Raising Awareness of a Fatal Complication of Epilepsy

Marshall Health’s department of neurology and the West Virginia Epilepsy Foundation are committed to educating the public about epilepsy and seizures, fighting social stigmas surrounding epilepsy and supporting fundraising and research for a cure.

This year, during Epilepsy Awareness Month, we hope to increase knowledge of a fatal complication of epilepsy. SUDEP is the sudden unexpected death of someone with epilepsy that is a non-traumatic and a non-drowning death. SUDEP is likely the most common cause of death from epilepsy complications, accounting for 7.5 to 17% of all epilepsy-related deaths and 50% of all refractory (uncontrolled) epilepsy deaths.

The underlying mechanisms of SUDEP are still poorly understood, but there are consistent risk factors including: increased refractory epilepsy, generalized tonic-clonic (convulsion) seizures, medication non-compliance, male gender, early age of seizure onset, certain genetic predisposition and being asleep during a seizure. Other SUDEP risk factors may include other circumstances such as seizure-induced hypoventilation and cardiac arrhythmias.

Currently, the most effective strategy to protect against SUDEP in childhood epilepsy is seizure control.  Other measures, however, that may be effective include seizure detection devices such as wristbands and watches, the use of seizure or baby monitors, avoidance of video games, alcohol and drugs and nighttime supervision.

Another way to reduce SUDEP risk is through epilepsy surgery or use of epilepsy neuromodulation devices (such as VNS, DBS and RNS) that result in increased seizure control.  Caregivers of individuals with epilepsy can decrease chances of SUDEP by maintaining knowledge of first-aid and rescue anti-seizure medication use.  Additionally, people with arrhythmias associated with seizures should be submitted to extensive cardiac investigation to determine the indication for on-demand cardiac pacing and should avoid anti-seizure medications that prolong the QT and PR intervals.

Although Epilepsy Awareness Month is just once a year, epilepsy treatment and advocacy is a priority at Marshall Neurology 365 days a year. For appointments, call 304-691-1787.

Patients and caregivers with questions should talk with their primary neurologist and seek support from the West Virginia Epilepsy Foundation (www.epilepsy.com/local/west-virginia) and Partners Against Mortality in Epilepsy (www.pameonline.org/).

This article appeared in the November 21, 2021, edition of the Herald Dispatch.