Sudden unexpected death in epilepsy

Sudden Unexpected Death in Epilepsy (SUDEP) refers to the sudden, unexpected death of a person with epilepsy that is not the result of trauma, drowning, or an identified medical condition. In most cases, no structural or toxicological cause of death is found at autopsy. SUDEP can occur with or without evidence of a preceding seizure, and is often unwitnessed, especially during sleep.

The exact mechanisms underlying SUDEP remain unclear but are believed to be multifactorial. Potential contributors include seizure-related disruptions in breathing, heart rhythm, or brain function, often in combination.

SUDEP is estimated to affect approximately 1 in 1,000 adults and 1 in 4,500 children with epilepsy each year. It accounts for 7% to 17% of epilepsy-related deaths overall, and up to 50% in those with refractory epilepsy. Deaths caused by status epilepticus or accidents such as drowning are classified separately.