Sudden unexpected death in epilepsy (SUDEP) - pathophysiological considerations sdfsaf

By definition, the diagnosis "SUDEP" means that the exact cause of death cannot be determined. The death is "without (obvious) explanation". Still, there are several hints to the underlying pathophysiological mechanisms of SUDEP. Epidemiologic studies have identified risk factors for the occurrence of SUDEP. These risk factors comprise, e.g., male sex, increased seizure frequency, subtherapeutic drug levels, frequently changing combinations of antiepileptic drugs. Autopsies of SUDEP victims demonstrated subendocardial myocardial ischemia or cerebral as well as pulmonary edema. The occurrence of SUDEP might be related to dysfunction of the central autonomic nervous system. Studies on epilepsy patients as well as animal experiments support the hypothesis that (inter) ictal epileptic activity leads to excessive sympathetic stimulation resulting in, e.g., neurogenic pulmonary edema, myocardial ischemia or cardiac arrhythmia. Further studies investigating the pathophysiology of SUDEP are necessary to establish reasonable preventive measures that might contribute to a reduction of the 2-to 5-fold increased mortality rates in epilepsy patients.