Abstracts

Rationale: Patients with epilepsy were reported to have significantly higher risk of sudden death than healthy subjects, which is called sudden unexpected death in epilepsy (SUDEP) . The exact underlying mechanisms of this phenomenon are not clear. There are no reports focusing on race difference in risk factors of SUDEP. The current status of SUDEP, including incidence and risk factors, has not been well studied in Japan.Methods: We reviewed medical records of 24 patients with epilepsy, who died between November 2005 and November 2010, out of approximately 1,400 outpatients per year in our clinic. These 24 patients were classified into the following 3 groups: probable SUDEP, possible SUDEP, and non-SUDEP. Then, we evaluated the patients profiles including gender, age of death, age at seizure onset, disease duration, seizure classification, and epilepsy classification. Results: Seven patients were classified into probable SUDEP (29.2%), 4 possible SUDEP, and 13 non-SUDEP. All 7 patients in probable SUDEP group were male. Average age of death, age at seizure onset, and disease duration were 36.1, 13.0, and 23.1 years, respectively. Six patients of them had generalized seizures and 5 were diagnosed as symptomatic localization-related epilepsy. On the other hand, 4 out of these 7 patients were taking only one antiepileptic drug. Three patients showed a good seizure control with seizure-free periods of 1, 3, and 10 years. Conclusions: Incidence of SUDEP is estimated to be about 1 case/1,000 person-years, as is similar to the previous reports. We also showed that most of the probable SUDEP patients had well-known risk factors such as male, young age, long disease duration, and presence of generalized seizures. However, quite a lot of patients under monotherapy and/or with long seizure-free periods, who have not been considered to be subject to SUDEP, were classified into probable SUDEP group. There may be race difference in the risk factors for SUDEP, although it is a small number study. Further studies are needed to clarify these differences.