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. 2021 Jul;62(7):1536-1545.
doi: 10.1111/epi.16928. Epub 2021 Jun 4.

Improving prediction of sudden unexpected death in epilepsy: From SUDEP-7 to SUDEP-3

Roozbeh Tarighati Rasekhi  1 , Kathryn N Devlin  2 , Joely A Mass  3 , Mustafa Donmez  4 , Burcu Asma  5 , Michael R Sperling  6 , Maromi Nei  6
Affiliations

Improving prediction of sudden unexpected death in epilepsy: From SUDEP-7 to SUDEP-3

Roozbeh Tarighati Rasekhi et al. Epilepsia. 2021 Jul.

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Epilepsia. 2021 Nov;62(11):2880. doi: 10.1111/epi.17075. Epub 2021 Sep 15. Epilepsia. 2021. PMID: 34523733 No abstract available.

Abstract

Objective: Sudden unexpected death in epilepsy (SUDEP) is a significant cause of mortality in epilepsy. The aim of this study is to evaluate the validity of the SUDEP-7 inventory and its components as tools for predicting SUDEP risk, and to develop and validate an improved inventory.

Methods: The study included 28 patients who underwent video-electroencephalography (EEG) monitoring and later died of SUDEP, and 56 age- and sex-matched control patients with epilepsy. The SUDEP-7 score, its individual components, and an alternative inventory were examined as predictors of SUDEP.

Results: SUDEP-7 scores were significantly higher among SUDEP patients compared with controls, both at time of admission (p = 0.024) and most recent follow-up (p = 0.016). SUDEP-7 scores declined only among controls, who demonstrated reduced seizure frequency. Seizure freedom after epilepsy surgery was also associated with survival. Several components of the SUDEP-7 inventory were independently associated with higher risk of SUDEP, including more than three generalized tonic-clonic (GTC) seizures (p = 0.002), one or more GTC seizures (p = 0.001), or one or more seizures of any type within the last year (p = 0.013), and intellectual disability (p = 0.031). In stepwise regression models, SUDEP-7 scores did not enhance the prediction of SUDEP over either GTC seizure frequency or seizure frequency alone. A novel SUDEP-3 inventory comprising GTC seizure frequency, seizure frequency, and intellectual disability (p < 0.001) outperformed the SUDEP-7 inventory (p = 0.010) in predicting SUDEP.

Significance: Our findings demonstrate the limitations of the SUDEP-7 inventory. We propose a new three-item SUDEP-3 inventory, which predicts SUDEP better than the SUDEP-7.

Keywords: SUDEP-7 inventory; epilepsy surgery; generalized seizures; sudden unexpected death in epilepsy.

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References

REFERENCES

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