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Unifying the definitions of sudden unexpected death in epilepsy
Open accessAbstract
Summary: Sudden unexpected death in epilepsy (SUDEP) is a category of death in people with epilepsy occurring in the absence of a known structural cause of death and is most likely heterogeneous with regard to mechanisms and circumstances. SUDEP is particularly difficult to investigate in research studies for several reasons, including its relatively low incidence, its unpredictable occurrence often in unwitnessed settings, and its low rate of complete autopsy examinations. Over the past two decades, two complementary definitions have been used in most SUDEP studies, but often with variations. We propose here a unified SUDEP definition and classification to resolve current ambiguities and to retrieve cases that would not have been further studied if the previous definitions were used. The proposed Unified SUDEP Definition and Classification contains, in addition to concepts inherent in the previous definitions, nine main recommendations. (1) The word “unexpected,” and not the word “unexplained,” should be uniformly used in the term SUDEP . (2) The SUDEP category should be applied when appropriate, whether or not a terminal seizure is known to have occurred. (3) The “Possible SUDEP” category should be used only for cases with competing causes of death, with cases left unclassified when data are insufficient to reasonably permit their classification. (4) Cases that would otherwise fulfill the definition of SUDEP should be designated as “SUDEP Plus” when evidence indicates that a preexisting condition, known before or after autopsy, could have contributed to the death, which otherwise is classified as SUDEP (e.g., coronary insufficiency with no evidence of myocardial infarction or long‐QT syndrome with no documented primary ventricular arrhythmia leading to death). (5) To be considered SUDEP, the death should have occurred within 1 h from the onset of a known terminal event. (6) For status epilepticus as an exclusion criterion for SUDEP, the duration of seizure activity should be 30 min or more. (7) A specific category of SUDEP due to asphyxia should not be designated, the distinction being largely impractical on circumstantial or autopsy evidence, with more than one mechanism likely to be contributory in many cases. (8) Death occurring in water but without circumstantial or autopsy evidence of submersion should be classified as “Possible SUDEP.” If any evidence of submersion is present, the death should not be classified as SUDEP. (9) A category of “Near‐SUDEP” should be agreed to include cases in which cardiorespiratory arrest was reversed by resuscitation efforts with subsequent survival for more than 1 h. Scenarios that demonstrate the basis for each SUDEP category are described. If disagreement exists about which category fits a particular case, we suggest the use of consensus decision by a panel of informed reviewers to adjudicate the classification of the case.
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“The primary cause of death is sudden unexpected death in epilepsy (SUDEP) 17 ; other causes include cerebral oedema following status epilepticus 18 , chest infections and accidental causes 19 .”
From Developmental and epileptic encephalopathies (2024) · cites this paper as [17]
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Cites
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Sorted by citations
Items 101–200 of 629
Scorza, F. A., do Carmo, A. C., FIORINI, A. C., Nejm, M. B., Scorza, C. A., Finsterer, J., & Ferraz, H. B. (2017) · Clinics · doi:10.6061/clinics/2017(11)01 · Cited by 52
Targeting Ferroptosis to Treat Cardiovascular Diseases: A New Continent to Be Explored
Huang, F., Yang, R., Xiao, Z., Xie, Y., Lin, X., Zhu, P., Zhou, P., Lu, J., & Zheng, S. (2021) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2021.737971 · Cited by 54
“Also, a recent research found that BTB and CNC homology 1 (BACH1), a regulator in heme and iron metabolism which could repress the transcription of erastin-induced protective genes, aggravates acute MI by promoting ferroptosis (Nishizawa et al., 2020).”
BackgroundReview: The past, present and future challenges in epilepsy‐related and sudden deaths and biobanking
Thom, M., Boldrini, M., Bundock, E. A., Sheppard, M. N., & Devinsky, O. (2017) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12453 · Cited by 51
McCarter, A. R., Timm, P. C., Shepard, P. W., Sandness, D. J., Luu, T. N., McCarter, S. J., Dueffert, L. G., Dresow, M., Feemster, J. C., Cascino, G. D., et al. (2018) · Epilepsia · doi:10.1111/epi.14548 · Cited by 53
“SUDEP is defined as sudden, unexpected, and nontraumatic death in patients with epilepsy in whom autopsy does not reveal a structural or toxic cause for death.(2) SUDEP may occur with or without evidence of a preceding seizure, with exclusion of documented status epilepticus.”
Self-citationRisk Factors for Sudden Unexpected Death in Epilepsy (SUDEP) and Their Mitigation
Whitney, R., & Donner, E. J. (2019) · Current Treatment Options in Neurology · doi:10.1007/s11940-019-0547-4 · Cited by 51
Richerson, G. B., Boison, D., Faingold, C. L., & Ryvlin, P. (2016) · Epilepsia · doi:10.1111/epi.13236 · Cited by 51
“There are many similarities between SUDEP and SIDS, including their definitions.(61,69) In both, it is common for”
BackgroundSelf-citationFaingold, C. L., & Feng, H. (2023) · Epilepsia · doi:10.1111/epi.17521 · Cited by 51
“83 F I G U R E 1 A generalized tonic– clonic seizure (1) causes release of neuroactive substances (2), including adenosine (3).”
BackgroundFaingold, C. L., Randall, M., Zeng, C., Peng, S., Long, X., & Feng, H.-J. (2016) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2016.09.034 · Cited by 46
Doumlele, K., Friedman, D. J., Buchhalter, J., Donner, E. J., Louik, J. B., & Devinsky, O. (2017) · JAMA Neurology · doi:10.1001/jamaneurol.2016.6126 · Cited by 46
Dramatic outcomes in epilepsy: depression, suicide, injuries, and mortality
Mesraoua, B., Deleu, D., Hassan, A. H., Melikyan, G., Lubna, A., Ali, M. A., Tomson, T., Khalil, B. A., Cross, J. H., & Asadi‐Pooya, A. A. (2020) · Current Medical Research and Opinion · doi:10.1080/03007995.2020.1776234 · Cited by 45
Self-citationSudden unexpected death in epilepsy: From the lab to the clinic setting
Terra, V. C., Cysneiros, R. M., Cavalheiro, É. A., & Scorza, F. A. (2013) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2012.12.018 · Cited by 44
“Sudden unexpected death in epilepsy (SUDEP) is characterized by death in the absence of a known structural cause and most likely involves heterogeneous mechanisms and circumstances [1].”
BackgroundCardiac and Autonomic Mechanisms Contributing to SUDEP
Bermeo-Ovalle, A. C., Kennedy, J. D., & Schuele, S. (2015) · Journal of Clinical Neurophysiology · doi:10.1097/wnp.0000000000000155 · Cited by 43
“The death is classified as “possible SUDEP” if an alternative cause of death is found and “probable SUDEP” if no alternative cause is not noted but no autopsy was performed (Devinsky, 2011; Nashef et al., 2012).”
BackgroundEpilepsy and Sleep-Related Breathing Disturbances
Somboon, T., Grigg-Damberger, M. M., & Foldvary‐Schaefer, N. (2019) · CHEST Journal · doi:10.1016/j.chest.2019.01.016 · Cited by 43
Fialho, G. L., Wolf, P., Walz, R., & Lin, K. (2019) · Seizure · doi:10.1016/j.seizure.2019.07.002 · Cited by 43
Mortality in infantile spasms: A hospital‐based study
Harini, C., Nagarajan, E., Bergin, A. M. R., Pearl, P. L., Loddenkemper, T., Takeoka, M., Morrison, P. F., Coulter, D. L., Harappanahally, G. V., Marti, C., et al. (2020) · Epilepsia · doi:10.1111/epi.16468 · Cited by 42
Kløvgaard, M., Lynge, T. H., Tsiropoulos, I., Uldall, P. V., Banner, J., Winkel, B. G., Ryvlin, P., Tfelt‐Hansen, J., & Sabers, A. (2021) · Epilepsia · doi:10.1111/epi.17037 · Cited by 42
Self-citationIncidence of cardiac fibrosis in SUDEP and control cases
Devinsky, O., Kim, A., Friedman, D. J., Bedigian, A., Moffatt, E., & Tseng, Z. H. (2018) · Neurology · doi:10.1212/wnl.0000000000005740 · Cited by 42
“SUDEP determination used the criteria of Nashef et al.(12) If there was any disagreement between the reviewers on epilepsy diagnosis or SUDEP determination, they discussed and agreed on a final determination.”
MethodSudden death in epilepsy: the overlap between cardiac and neurological factors
Shlobin, N. A., Thijs, R. D., Benditt, D. G., Zeppenfeld, K., & Sander, J. W. A. S. (2024) · Brain Communications · doi:10.1093/braincomms/fcae309 · Cited by 43
Radhakrishnan, D. M., Ramanujam, B., Srivastava, M. V. P., Dash, D., & Tripathi, M. (2018) · Acta Neurologica Scandinavica · doi:10.1111/ane.12994 · Cited by 41
Circuits generating secondarily generalized seizures
Brodovskaya, A., & Kapur, J. (2019) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2019.106474 · Cited by 41
“SUDEP is a sudden, unexpected, nontraumatic and nondrowning death in patients with epilepsy, with or without evidence of seizures and excluding documented status epilepticus, in which postmortem examination does not reveal toxicologic or anatomic cause of death [2].”
BackgroundToward automated prediction of sudden unexpected death in epilepsy
Gu, B., & Adeli, H. (2022) · Reviews in the Neurosciences · doi:10.1515/revneuro-2022-0024 · Cited by 40
Menon, R. N., & Cross, J. H. (2025) · The Lancet · doi:10.1016/s0140-6736(25)00773-1 · Cited by 40
Understanding Death in Children With Epilepsy
Donner, E. J., CAMFIELD, P. R., Brooks, L., Buchhalter, J., Camfield, C., Loddenkemper, T., & Wirrell, E. C. (2017) · Pediatric Neurology · doi:10.1016/j.pediatrneurol.2017.01.011 · Cited by 40
Sudden unexpected death in epilepsy: A critical view of the literature
Giussani, G., Falcicchio, G., Neve, A. L., Costagliola, G., Striano, P., Scarabello, A., Mostacci, B., Beghi, E., & the LICE SUDEP study group (2023) · Epilepsia Open · doi:10.1002/epi4.12722 · Cited by 41
“224 wrote an evidencebased safety checklist for clinicians to quickly identify well- recognized risk factors of SUDEP (subdivided into static and modifiable risk factors) in order to minimize them and promote safety: (1) static factors: male sex, duration of epilepsy, unclear treatment history, primary generalized epi…”
BackgroundNaggar, I. C., Lazar, J., Kamran, H., Orman, R., & Stewart, M. (2013) · Epilepsy Research · doi:10.1016/j.eplepsyres.2013.10.018 · Cited by 40
Refractory Epilepsy in Children
Aneja, S., & Jain, P. (2014) · Indian Journal of Pediatrics · doi:10.1007/s12098-014-1533-1 · Cited by 34
“The adult studies have identified many risk factors for SUDEP and include high seizure frequency especially generalized tonicclonic seizures, polytherapy, early onset of epilepsy ( 15 y) and associated intellectual disability [58].”
MEDCIS: Multi-Modality Epilepsy Data Capture and Integration System.
Zhang, G., Cui, L., Lhatoo, S. D., Schuele, S., & Sahoo, S. S. (2014) · PubMed Central · Cited by 39
Prevention of sudden unexpected death in epilepsy: current status and future perspectives
Pensel, M. C., Nass, R. D., Taubøll, E., Aurlien, D., & Surges, R. (2020) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2020.1754195 · Cited by 38
“Definitions of SUDEP (according to [1]).”
All-cause mortality and SUDEP in a surgical epilepsy population
Casadei, C. H., Carson, K. W., Mendiratta, A., Bazil, C. W., Pack, A. M., Choi, H., Srinivasan, S., McKhann, G. M., Schevon, C. A., & Bateman, L. M. (2020) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2020.107093 · Cited by 38
“unified definition was used for classification of deaths as SUDEP [6], with cases adjudicated by two board-certified epileptologists (LMB, CAS) on review of available clinical data, including medical records, death certificates and autopsy reports.”
MethodMyocardial Iron Overload in an Experimental Model of Sudden Unexpected Death in Epilepsy
Akyüz, E., Doğanyiğit, Z., Eroğlu, E., Moscovicz, F., Merelli, A., Lazarowski, A., & Auzmendi, J. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.609236 · Cited by 38
“Although the mechanism that triggers sudden death is unknown, several lines of evidence suggest that SUDEP could be due to a terminal cardiac arrhythmia as a consequence of a highly frequent seizure-triggered hypoxic-stress plus excessive sympathetic overstimulation that triggers neurocardiogenic injury and affects el…”
BackgroundSocioeconomic disparities in SUDEP in the US
Cihan, E., Hesdorffer, D. C., Brandsoy, M., Li, L., Fowler, D. R., Graham, J. K., Karlovich, M. W., Donner, E. J., Devinsky, O., & Friedman, D. J. (2020) · Neurology · doi:10.1212/wnl.0000000000009463 · Cited by 37
“Appropriate deaths were classified as definite SUDEP, definite SUDEP plus, probable SUDEP, probable SUDEP plus, possible SUDEP, and near SUDEP based on previously published criteria.(18) When there was a disagreement as to the cause of death or SUDEP classification, a third reviewer (E.”
MethodElectrocardiographic features of sudden unexpected death in epilepsy
Chyou, J. Y., Friedman, D. J., Cerrone, M., Slater, W., Guo, Y., Taupin, D., O’Rourke, S., Priori, S. G., & Devinsky, O. (2016) · Epilepsia · doi:10.1111/epi.13411 · Cited by 37
“SUDEP was defined and classified (as definite, probable, and possible) using the criteria of Nashef et al.(3) There were 22 patients with SUDEP; of these, 12 had an interpretable 12-lead resting ECG and concurrent medication list and were thereby eligible for inclusion in this study.”
MethodSeizure induced ventricular fibrillation: A case of near-SUDEP
Ferlisi, M., Tomei, R., Carletti, M., Moretto, G., & Zanoni, T. (2013) · Seizure · doi:10.1016/j.seizure.2012.12.008 · Cited by 36
Improving prediction of sudden unexpected death in epilepsy: From SUDEP‐7 to SUDEP‐3
Rasekhi, R. T., Devlin, K. N., Mass, J. A., Donmez, M., Asma, B., Sperling, M. R., & Nei, M. (2021) · Epilepsia · doi:10.1111/epi.16928 · Cited by 36
After sudden unexpected death in epilepsy: Lessons learned and the road forward
Donner, E. J., Waddell, B., Osland, K., Leach, J. P., Duncan, S., Nashef, L. A. M., & Picot, M. (2016) · Epilepsia · doi:10.1111/epi.13235 · Cited by 35
“SUDEP was classified as per Nashef, et al.(8) Data collected are listed in Table 1.”
MethodSelf-citationMichalak, Z., Obari, D., Ellis, M. J., Thom, M., & Sisodiya, S. M. (2017) · Neurology · doi:10.1212/wnl.0000000000003584 · Cited by 35
Cardiac Investigations in Sudden Unexpected Death in DEPDC5 ‐Related Epilepsy
Bacq, A., Roussel, D., Bonduelle, T., Zagaglia, S., Maletic, M., Ribierre, T., Adle‐Biassette, H., Marchal, C., Jennesson, M. M., Gourfinkel‐An, I., et al. (2021) · Annals of Neurology · doi:10.1002/ana.26256 · Cited by 35
Expert opinion on diagnosis and management of epilepsy‐associated comorbidities
Peltola, J., Surges, R., Voges, B. R., & von Oertzen, T. J. (2023) · Epilepsia Open · doi:10.1002/epi4.12851 · Cited by 34
“37 It is difficult to provide reliable estimates of SUDEP and SCD incidence rates in PwE as the available epidemiological studies did not assess both entities in the same population.”
BackgroundEpilepsy-Related Mortality in Children and Young Adults in Denmark
Kløvgaard, M., Lynge, T. H., Tsiropoulos, I., Uldall, P. V., Banner, J., Winkel, B. G., Ryvlin, P., Tfelt‐Hansen, J., & Sabers, A. (2021) · Neurology · doi:10.1212/wnl.0000000000013068 · Cited by 34
“SUDEP was defined by the unified criteria as sudden, unexpected, nontraumatic, and nondrowning death, excluding status epilepticus, and no identification of a cause of death at the postmortem examination.(17) We categorized SUDEP as definite when all criteria were fulfilled, definite plus when all criteria were fulfil…”
InfluentialSelf-citationSudden Death and Cardiac Arrythmia With Lamotrigine
Bunschoten, J. W., Husein, N., Devinsky, O., French, J. A., Sander, J. W. A. S., Thijs, R. D., & Keezer, M. R. (2022) · Neurology · doi:10.1212/wnl.0000000000200164 · Cited by 34
“, not due to drowning, injury, intoxication, or other internal or external factors), where evidence of a preceding seizure may or may not be present.(8) A death is generally labelled as definite SUDEP if a postmortem examination does not reveal an alternative cause of death.”
BackgroundSudden unexpected death in epilepsy: Respiratory mechanisms
Teran, F. A., Bravo, E., & Richerson, G. B. (2022) · Handbook of clinical neurology · doi:10.1016/b978-0-323-91532-8.00012-4 · Cited by 35
Mortality in isodicentric chromosome 15 syndrome: The role of SUDEP
Friedman, D. J., Thaler, A. I., Thaler, J., Rai, S., Cook, E. H., Schanen, C., & Devinsky, O. (2016) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2016.04.001 · Cited by 34
“myocardial infarction, drug intoxication); seizure stigmata such as tongue or cheek bite or pulmonary edemamay be present [6].”
BackgroundOchoa‐Urrea, M., Luo, X., Vilella, L., Lacuey, N., Omidi, S. J., Hupp, N. J., Talavera, B., Hampson, J. P., Rani, M. R. S., Tao, S., et al. (2025) · The Lancet · doi:10.1016/s0140-6736(25)01636-8 · Cited by 33
A population-based post mortem study of sudden unexpected death in epilepsy
Clark, D., & Riney, K. (2015) · Journal of Clinical Neuroscience · doi:10.1016/j.jocn.2015.04.027 · Cited by 33
“system has been published [12].”
Reducing the Risk of Sudden Unexpected Death in Epilepsy (SUDEP)
Watkins, L. V., & Shankar, R. (2018) · Current Treatment Options in Neurology · doi:10.1007/s11940-018-0527-0 · Cited by 33
Scurrying to Understand Sudden Expected Death in Epilepsy: Insights From Animal Models
Li, R., & Buchanan, G. F. (2019) · Epiliepsy currents/Epilepsy currents · doi:10.1177/1535759719874787 · Cited by 33
“Sudden unexpected death in epilepsy is defined as the sudden, unexpected, witnessed or unwitnessed, nontraumatic, and nondrowning death in a patient with epilepsy, excluding known status epilepticus and in who the postmortem examination provides no structural or toxicological causes of death.(5) Sudden unexpected deat…”
BackgroundBellon, M., Panelli, R. J., & Rillotta, F. (2015) · Seizure · doi:10.1016/j.seizure.2015.05.007 · Cited by 32
“All rights re Epilepsy (SUDEP) [4,5], the most common cause of epilepsyrelated death [6].”
The role of antiepileptic drugs in sudden unexpected death in epilepsy
Aurlien, D., Gjerstad, L., & Taubøll, E. (2016) · Seizure · doi:10.1016/j.seizure.2016.11.005 · Cited by 32
To reveal or conceal? Adult patient perspectives on SUDEP disclosure
Long, L., Cotterman-Hart, S., & Shelby, J. N. (2018) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2018.06.026 · Cited by 32
Allen, L. A., Harper, R. M., Guye, M., Kumar, R., Ogren, J. A., Vos, S. B., Sebastien Ourselin, A., Scott, C. A., Lhatoo, S. D., Lemieux, L., et al. (2019) · NeuroImage Clinical · doi:10.1016/j.nicl.2019.102060 · Cited by 32
SUDEP risk and autonomic dysfunction in genetic epilepsies
Sahly, A. N., Shevell, M. I., Sadleir, L. G., & Myers, K. A. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102907 · Cited by 32
Unexpected death in palliative care
Hui, D. (2015) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000174 · Cited by 32
Sudden unexpected death in epilepsy. A nationwide population‐based study
Einarsdottir, A. B., Sveinsson, O. A., & Ólafsson, E. (2019) · Epilepsia · doi:10.1111/epi.16349 · Cited by 31
“modified the definition of SUDEP in 2012, which is used in this study.(16) Definite SUDEP cases meet all the above criteria.”
MethodPatodia, S., Tachrount, M., Somani, A., Scheffer, I. E., Yousry, T. A., Golay, X., Sisodiya, S. M., & Thom, M. (2020) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12638 · Cited by 31
Are Variants Causing Cardiac Arrhythmia Risk Factors in Sudden Unexpected Death in Epilepsy?
Bleakley, L. E., Soh, M. S., Bagnall, R. D., Sadleir, L. G., Gooley, S., Semsarian, C., Scheffer, I. E., Berkovic, S. F., & Reid, C. A. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00925 · Cited by 31
“SUDEP is defined as “a sudden, unexpected, witnessed or unwitnessed, nontraumatic and non-drowning death, occurring in benign circumstances, in an individual with epilepsy, with or without evidence for a seizure and excluding documented status epilepticus, in which postmortem examination does not reveal a cause of dea…”
BackgroundCooper, K., Kirkpatrick, P., Brand, C., Rolfe, A., & Florida-James, S. (2019) · Seizure · doi:10.1016/j.seizure.2019.10.002 · Cited by 30
“Due to difficulties with 80 definitive diagnosis it is increasingly classified as definite, probable or possible 81 [1].”
BackgroundInfluentialCardiac adverse effects of antiseizure medications
Zaccara, G., Lattanzi, S., & Brigo, F. (2021) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2022.2023128 · Cited by 30
“In 2012, four cases of SUDEP have been reported in women with idiopathic epilepsy on LTG monotherapy [107] and more recently, in a case-control study, the incidence of SUDEP was significantly higher among female epilepsy patients treated with LTG [108].”
BackgroundInfluentialAn explanation for sudden death in epilepsy (SUDEP)
Stewart, M. (2018) · The Journal of Physiological Sciences · doi:10.1007/s12576-018-0602-z · Cited by 29
“A “plus” designation attached to the “definite” or “probable” definitions is used “when a concomitant condition other than epilepsy is identified before or after death, if the death may have been due to the combined effect of both conditions, and if autopsy or direct observations/recordings of terminal event did not p…”
BackgroundA national study of epilepsy‐related deaths in Scotland: Trends, mechanisms, and avoidable deaths
Mbizvo, G. K., Schnier, C., Simpson, C. R., Chin, R., & Duncan, S. (2021) · Epilepsia · doi:10.1111/epi.17065 · Cited by 29
Sullivan, B. J., Kipnis, P. A., Carter, B. M., Shao, L., & Kadam, S. D. (2021) · Science Signaling · doi:10.1126/scisignal.abg2648 · Cited by 29
“This indicated that the prevention of Ser940 phosphorylation increased the risk of sudden unexpected death in epilepsy–like phenomenon (42).”
BackgroundThe Epileptic Heart Syndrome: Epidemiology, pathophysiology and clinical detection
Verrier, R. L., & Schachter, S. C. (2024) · Epilepsy & Behavior Reports · doi:10.1016/j.ebr.2024.100696 · Cited by 28
The ERG1 K+ Channel and Its Role in Neuronal Health and Disease
Sanchez-Conde, F. G., Jiménez‐Vázquez, E. N., Auerbach, D. S., & Jones, D. K. (2022) · Frontiers in Molecular Neuroscience · doi:10.3389/fnmol.2022.890368 · Cited by 28
Derera, I. D., Delisle, B. P., & Smith, B. N. (2017) · eNeuro · doi:10.1523/eneuro.0319-17.2017 · Cited by 28
Evangelista, G., Dono, F., Consoli, S., Lanzone, J., Corniello, C., Russo, M., Anzellotti, F., ONOFRJ, M. C., Vollono, C., & Sensi, S. L. (2023) · European Journal of Neurology · doi:10.1111/ene.15792 · Cited by 27
Incidence of sudden unexpected death in nocturnal frontal lobe epilepsy: a cohort study
Mostacci, B., Bisulli, F., Vignatelli, L., Licchetta, L., Vito, L. D., Rinaldi, C., Trippi, I., Ferri, L., Plazzi, G., Provini, F., et al. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2014.09.019 · Cited by 28
“According to the newly proposed criteria [14], the diagnosis was reformulated into ‘Probable SUDEP Plus’.”
MethodLong-term follow-up and sudden unexpected death in Gaucher disease type 3 in Egypt
Abdelwahab, M. S., Blankenship, D., & Schiffmann, R. (2016) · Neurology Genetics · doi:10.1212/nxg.0000000000000055 · Cited by 27
“In these cases, sudden unexpected death in epilepsy (SUDEP) can be invoked.(21,22) The incidence of SUDEP in our study population is much higher than that described in various epilepsy populations (0.”
BackgroundCauses of mortality in early infantile epileptic encephalopathy: A systematic review
Radaelli, G., Santos, F. D. S., Borelli, W. V., Pisani, L., Nunes, M. L., Scorza, F. A., & da Costa, J. C. (2018) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2018.05.015 · Cited by 27
Autopsy‐reported cause of death in a population‐based cohort of sudden unexpected death in epilepsy
Keller, A. E., Ho, J., Whitney, R., Li, S., Williams, A. S., Pollanen, M. S., & Donner, E. J. (2021) · Epilepsia · doi:10.1111/epi.16793 · Cited by 27
Epilepsy and Cardiac Arrhythmias
Ha, F. J., Chong, T., Cook, M. J., & Paratz, E. D. (2024) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2024.09.034 · Cited by 26
Cardiac Autonomic Dysfunction and Risk of Sudden Unexpected Death in Epilepsy
Szurhaj, W., Leclancher, A., Nica, A., Périn, B., Derambure, P., Convers, P., Mazzola, L., Godet, B., Faucanié, M., Picot, M., et al. (2021) · Neurology · doi:10.1212/wnl.0000000000011998 · Cited by 26
Harden, J., Tonberg, A., Chin, R., McLellan, A. E., & Duncan, S. (2014) · Chronic Illness · doi:10.1177/1742395314557705 · Cited by 26
“SUDEP is characterised by ‘death in the absence of known structural cause’.(2) It is described as being sudden, unexpected, not as result of trauma or drowning and without any toxicological or anatomical cause detected during post mortem.”
BackgroundThe SUDEP Risk Inventory: Association with postictal generalized EEG suppression
Moseley, B. D., & DeGiorgio, C. M. (2015) · Epilepsy Research · doi:10.1016/j.eplepsyres.2015.09.006 · Cited by 26
Deciphering the premature mortality in PIGA-CDG – An untold story
Bayat, A., Kløvgaard, M., Johannesen, K. M., Barakat, T. S., Maat‐Kievit, A., Montomoli, M., Parrini, E., Pietrafusa, N., Schelhaas, J. H., van Slegtenhorst, M., et al. (2020) · Epilepsy Research · doi:10.1016/j.eplepsyres.2020.106530 · Cited by 26
Sudden unexpected death in epilepsy
Duble, S. N., & Thomas, S. V. (2017) · The Indian Journal of Medical Research · doi:10.4103/ijmr.ijmr_548_17 · Cited by 25
Sudden unexpected death in epilepsy in children: a focused review of incidence and risk factors
Saxena, A., Jones, L., Shankar, R., McLean, B., Newman, C. G. J., & Hamandi, K. (2018) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2017-317702 · Cited by 25
Asadollahi, M., Noorbakhsh, M., Simani, L., Ramezani, M., & Gharagozli, K. (2018) · Seizure · doi:10.1016/j.seizure.2018.08.009 · Cited by 25
Trivisano, M., Muccioli, L., Ferretti, A., Lee, H.-F., Chi, C., & Bisulli, F. (2021) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2021.107896 · Cited by 25
Pediatric Sudden Unexpected Death in Epilepsy
Morse, A. M., & Kothare, S. V. (2016) · Pediatric Neurology · doi:10.1016/j.pediatrneurol.2016.01.004 · Cited by 25
Sudden Unexpected Death in Epilepsy
Ellis, S. P., & Szabó, C. Á. (2018) · American Journal of Forensic Medicine & Pathology · doi:10.1097/paf.0000000000000394 · Cited by 25
Magana‐Tellez, O., Maganti, R. K., Hupp, N. J., Luo, X., Rani, S., Hampson, J. P., Ochoa‐Urrea, M., Tallavajhula, S. S., Sainju, R. K., Friedman, D. J., et al. (2025) · The Lancet Neurology · doi:10.1016/s1474-4422(25)00273-x · Cited by 24
Adrenergic Mechanisms of Audiogenic Seizure-Induced Death in a Mouse Model of SCN8A Encephalopathy
Wengert, E. R., Wenker, I. C., Wagner, E. L., Wagley, P. K., Gaykema, R. P. A., Shin, J., & Patel, M. K. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.581048 · Cited by 24
Review: Neuropathology findings in autonomic brain regions in SUDEP and future research directions
Patodia, S., Somani, A., & Thom, M. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102862 · Cited by 24
Update on Sudden Unexpected Death in Epilepsy
Kløvgaard, M., Sabers, A., & Ryvlin, P. (2022) · Neurologic Clinics · doi:10.1016/j.ncl.2022.06.001 · Cited by 24
Self-citationSudden unexpected death in epilepsy during cenobamate clinical development
Rosenfeld, W. E., Ferrari, L., Kerr, W. T., & Sperling, M. R. (2023) · Epilepsia · doi:10.1111/epi.17662 · Cited by 26
Genetics and SUDEP: Challenges and Future Directions
Whitney, R., Sharma, S., Jones, K., & RamachandranNair, R. (2023) · Seizure · doi:10.1016/j.seizure.2023.07.002 · Cited by 24
Bitemporal seizure spread and its effect on autonomic dysfunction
Page, T., & Rugg‐Gunn, F. J. (2018) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2018.03.016 · Cited by 24
“SUDEP is defined as the sudden and unexpected, non-traumatic and non-drowning death of a person with epilepsy, without a toxicological or anatomical cause of death detected during the post-mortem examination[3].”
BackgroundKv1.1 channel subunits in the control of neurocardiac function
Glasscock, E. (2019) · Channels · doi:10.1080/19336950.2019.1635864 · Cited by 24
“SUDEP is generally defined as the sudden unexpected death of someone with epilepsy, who is otherwise healthy, for which no obvious cause of death can be found [37].”
BackgroundA case of near-sudden unexpected death in epilepsy due to ventricular fibrillation
Seo, M. H., & Sung, W. Y. (2019) · Open Access Emergency Medicine · doi:10.2147/oaem.s214619 · Cited by 24
“Discussion Near-SUDEP is defined as more than 1-hr survival from cardiopulmonary arrest after a seizure that has no identified structural cause after investigation.(8)”
BackgroundMapping of Neuro-Cardiac Electrophysiology: Interlinking Epilepsy and Arrhythmia
Senapati, S. G., Bhanushali, A. K., Lahori, S., Naagendran, M. S., Sriram, S. A., Ganguly, A., Pusa, M., Damani, D. N., Kulkarni, K., & Arunachalam, S. P. (2023) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd10100433 · Cited by 23
Are we there yet? A critical evaluation of sudden and unexpected death in epilepsy models
Smith, J., Richerson, G. B., Kouchi, H., Duprat, F., Mantegazza, M., Bezin, L., & Rheims, S. (2023) · Epilepsia · doi:10.1111/epi.17812 · Cited by 23
Fialho, G. L., Pagani, A. G., Walz, R., Wolf, P., & Lin, K. (2017) · Epilepsy Research · doi:10.1016/j.eplepsyres.2017.04.014 · Cited by 24
“SUDEP has been defined as the sudden, unexpected, witnessed or unwitnessed, nontraumatic, and non-drowning death in PWE, with or without evidence for a seizure, with exclusion of documented status epilepticus, and when post-mortem examination does not reveal a structural or toxicological cause for death (Nashef, 1997;…”
BackgroundA Murine Model to Study Epilepsy and SUDEP Induced by Malaria Infection
Ssentongo, P., Robuccio, A. E., Thuku, G., Sim, D. G., Nabi, A., Bahari, F., Shanmugasundaram, B., Billard, M. W., Geronimo, A. M., Short, K. W., et al. (2017) · Scientific Reports · doi:10.1038/srep43652 · Cited by 23
Sudden unexpected death in epilepsy: ongoing challenges in finding mechanisms and prevention
Ruthirago, D., Julayanont, P., Karukote, A., Shehabeldin, M., & NUGENT, K. M. (2018) · International Journal of Neuroscience · doi:10.1080/00207454.2018.1466780 · Cited by 23
“In 2012, a unified SUDEP definition and classification were proposed to resolve ambiguities and for reference in research [4].”
BackgroundSazgar, M., & Young, M. G. (2019) · Springer eBooks · doi:10.1007/978-3-030-03511-2_2 · Cited by 23
Patodia, S., Paradiso, B., Ellis, M. J., Somani, A., Sisodiya, S. M., Devinsky, O., & Thom, M. (2019) · Epilepsy Research · doi:10.1016/j.eplepsyres.2019.106213 · Cited by 23
“The SUDEP group included 11 definite SUDEP cases (complete and negative autopsy including toxicology), the remaining 9 being probable or possible SUDEP according to current definitions (Nashef et al., 2012).”
Genetic generalized and focal epilepsy prevalence in the North American SUDEP Registry
Verducci, C., Friedman, D. J., Donner, E. J., & Devinsky, O. (2020) · Neurology · doi:10.1212/wnl.0000000000009295 · Cited by 22
“A total of 262 cases were adjudicated as definite, definite plus, or probable SUDEP using Nashef et al.(20) criteria.”
MethodStratifying sudden death risk in adults with drug‐resistant focal epilepsy: The SUDEP‐CARE score
Serrand, C., Rheims, S., Faucanié, M., Crespel, A., Dinkelacker, V., Szurhaj, W., Biraben, A., Bartoloméi, F., Grissac, N. D., Landré, E., et al. (2022) · European Journal of Neurology · doi:10.1111/ene.15566 · Cited by 22
Self-citationDead in the water: Epilepsy‐related drowning or sudden unexpected death in epilepsy ?
Cihan, E., Hesdorffer, D. C., Brandsoy, M., Li, L., Fowler, D. R., Graham, J. K., Donner, E. J., Devinsky, O., & Friedman, D. J. (2018) · Epilepsia · doi:10.1111/epi.14546 · Cited by 22
“When appropriate, deaths were classified as definite SUDEP, definite SUDEP plus, probable SUDEP, probable SUDEP plus, possible SUDEP, and near SUDEP, using the criteria of Nashef et al.(23) Definite drowning was defined as the decedent being witnessed to submerge into water or being found with mouth and nose covered i…”
MethodSchwab, C., Wadle, N., Knake, S., von Podewils, F., Siebenbrodt, K., Kohlhase, K. D., Schulz, J., Menzler, K., Mann, C., Rosenow, F., et al. (2021) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2021.108343 · Cited by 22
The insula lobe and sudden unexpected death in epilepsy: a hypothesis
Li, J., Ming, Q., & Lin, W. (2017) · Epileptic Disorders · doi:10.1684/epd.2017.0890 · Cited by 22
Metadata
- Authors
- Nashef, L., So, E. L., Ryvlin, P., & Tomson, T.
- Affiliations
- King's College Hospital (GB)
- Mayo Clinic (US)
- Lyon 1 Université (FR)
- Karolinska Institutet (SE)
- Corresponding author
- So, Elson L.
- Venue
- Epilepsia
- Publisher
- Wiley
- Published
- 2011-12-22
- Volume
- 53
- Issue
- 2
- Pages
- 227-233
- ISSN
- 0013-9580 (ISSN-L)
- 1528-1167
- OpenAlex
- W1549808427
- Cited by
- 632
- References
- 26
- Citations by year
- 2026: 34 · 2025: 54 · 2024: 39 · 2023: 57 · 2022: 38 · 2021: 70 · 2020: 69 · 2019: 59 · 2018: 55 · 2017: 39 · 2016: 30 · 2015: 35 · 2014: 24 · 2013: 20 · 2012: 8
- FWCI
- 11.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epilepsia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Epilepsy research and treatment
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Keywords
- sudden unexpected death in epilepsy, status epilepticus, cardiac arrest, SUDEP incidence, SUDEP risk factors, SUDEP prevention
- MeSH terms
- Death, Sudden, Epilepsy, Humans
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