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A systematic review of sudden unexpected death in epilepsy (SUDEP) in childhood

Abdel-Mannan, O; Taylor, H; Donner, EJ; Sutcliffe, AG; (2019) A systematic review of sudden unexpected death in epilepsy (SUDEP) in childhood. Epilepsy & Behavior , 90 pp. 99-106. 10.1016/j.yebeh.2018.11.006. Green open access

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Abstract

Background Sudden Unexpected Death in Epilepsy (SUDEP) is a significant cause of death in childhood epilepsy, and causes considerable concern to patients and their families. Despite this, the condition remains poorly understood. This systematic review investigates the risk factors, pathophysiology, and circumstances associated with childhood SUDEP. It aimed to explore the etiology of SUDEP and inform clinicians approaching SUDEP risk disclosure. Methods A structured electronic database search of MEDLINE, CENTRAL, EMBASE, and ISI web of science was conducted. Studies were included if they described clinical details of one or more patients, aged 18 years of age and below, who had SUDEP. Two reviewers independently reviewed each article for data extraction and quality assessment. Results Information on 108 cases of pediatric SUDEP was extracted from 22 included studies. These comprised five cohort studies, four retrospective case control studies, seven case series, and five case reports. Factors that appeared to be linked to pediatric SUDEP included those associated with severe epilepsy (early age of onset, high seizure frequency, intellectual impairment and developmental delay, multiple antiepileptic drug therapy, and structural abnormalities). The majority of included studies was noncomparative and had significant risk of bias. Conclusions There is currently insufficient evidence to determine the etiology of pediatric SUDEP. Current best practice to prevent pediatric SUDEP is to optimize the management of epilepsy. A national SUDEP registry would provide invaluable high-quality data and insights into modifiable risk factors, genetic predispositions, and novel prevention strategies.

Type: Article
Title: A systematic review of sudden unexpected death in epilepsy (SUDEP) in childhood
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.yebeh.2018.11.006
Publisher version: https://doi.org/10.1016/j.yebeh.2018.11.006
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Behavioral Sciences, Clinical Neurology, Psychiatry, Neurosciences & Neurology, Sudden Unexpected Death in Epilepsy, Sudden Unexplained Death in Epilepsy, SUDEP, Epidemiology, Epilepsy mortality, UNEXPLAINED DEATH, RISK-FACTORS, GENETIC-ANALYSIS, LONG-TERM, MORTALITY, CHILDREN, COHORT, DEFINITIONS, SEIZURE, RATES
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neuroinflammation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10068188
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