Devinsky, O;
Sisodiya, SM;
(2020)
SUDEP: Advances and Challenges.
Epilepsy Currents
10.1177/1535759720947438.
(In press).
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Abstract
During the past 2 decades, lay and academic awareness of sudden unexpected death in epilepsy (SUDEP) has increased tremendously, generating much discussion and research. In looking back, we tend to focus on progress, and there has been much. But we should also focus on roadblocks and failures. Patients with epilepsy and their families, as well as neurologists and medical examiners, are much more familiar with SUDEP than they were in 2000. Research has exploded. Between 1970 and 2000, the National Library of Medicine (PubMed) identified 109 articles on SUDEP. In the subsequent 20 years, more than 1300 additional articles were published, an increase from 3.6 to 65 articles/year. Yet, our challenges remain larger than our successes. We do not understand why some seizures are fatal while others are not; why some succumb to SUDEP after a few seizures and others survive hundreds of similar seizures; we lack validated SUDEP biomarkers and accurate serial incidence data from large populations; we have yet to initiate an interventional SUDEP prevention trial, and we have not reduced health care disparities that increase epilepsy-related mortality. Paradoxically, these challenges prevent us from knowing if any of our successes have led to a reduction in the SUDEP rate. Reflecting the current situation, this commentary is organized into 3 parts: (1) the big picture—how have our fundamental concepts about SUDEP changed? (2) what have been the major advances in SUDEP research and preventive strategies, and (3) what challenges remain?
| Type: | Article |
|---|---|
| Title: | SUDEP: Advances and Challenges |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/1535759720947438 |
| Publisher version: | https://doi.org/10.1177/1535759720947438 |
| Language: | English |
| Additional information: | This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
| 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 > Clinical and Experimental Epilepsy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10113398 |
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