SEIN- Epilepsy Institute in the Netherlands Foundation, Heemstede, The Netherlands.
Epilepsia. 2012 Feb;53(2):253-7. doi: 10.1111/j.1528-1167.2011.03360.x. Epub 2011 Dec 22.
Most people with epilepsy who die suddenly and whose death is attributed to sudden unexpected death in epilepsy (SUDEP) are found in or by the bed for unknown reasons. We assessed whether those with sleep-related SUDEP were more likely to have nocturnal seizures, and whether seizure patterns (diurnal vs. nocturnal) differed from people dying suddenly and living controls with epilepsy.
Seizure patterns in a cohort of 154 people with epilepsy who died suddenly and after autopsy conformed to the definition of SUDEP and 616 controls living with epilepsy were classified as having "exclusively diurnal" or "nocturnal seizures." Comparisons were made between the groups. SUDEP was classified as sleep-related or non-sleep-related based on eyewitness accounts and the circumstances surrounding death.
SUDEP was primarily a sleep-related (58%) and unwitnessed (86%) event. If sleep-related, SUDEP was more likely to be unwitnessed [odds ratio (OR) 4.4, 95% confidence interval (CI) 1.6-12]. Those with sleep-related SUDEP were more likely to have a history of nocturnal seizures than those who had non-sleep-related SUDEP (OR 3.6, 95% CI 1.4-9.4). Those who died were more likely to have a history of nocturnal seizures than living controls (OR 3.9, 95% CI 2.5-6.0). After correction for previously established SUDEP risk factors (Langan et al., 2005), the presence of nocturnal seizures remained significant (OR 2.6, 95% CI 1.3-5.0).
Nocturnal seizures seem to be an independent risk factor for SUDEP. These findings underscore the importance of preventive measures, which may include night supervision.
大多数因癫痫猝死（SUDEP）而突然死亡且死因归因于 SUDEP 的癫痫患者，其死亡地点或在床边，原因不明。我们评估了那些与睡眠相关的 SUDEP 是否更有可能出现夜间发作，以及发作模式（日间与夜间）是否与突然死亡且患有癫痫的生活对照者不同。
对 154 名经尸检证实为突然死亡且符合 SUDEP 定义的癫痫患者队列中的发作模式进行分类，将 616 名患有癫痫的生活对照者分为“仅日间发作”或“夜间发作”。对两组进行比较。根据目击者的陈述和死亡周围的情况，将 SUDEP 分为与睡眠相关或非睡眠相关。
SUDEP 主要是与睡眠相关（58%）和无人目击（86%）的事件。如果与睡眠相关，SUDEP 更有可能无人目击[优势比（OR）4.4，95%置信区间（CI）1.6-12]。与非睡眠相关的 SUDEP 相比，有睡眠相关 SUDEP 的患者更有可能有夜间发作史（OR 3.6，95% CI 1.4-9.4）。与生活对照者相比，死亡者更有可能有夜间发作史（OR 3.9，95% CI 2.5-6.0）。在校正了之前确定的 SUDEP 风险因素（Langan 等人，2005 年）后，夜间发作的存在仍然具有显著性（OR 2.6，95% CI 1.3-5.0）。
夜间发作似乎是 SUDEP 的一个独立危险因素。这些发现强调了预防措施的重要性，其中可能包括夜间监护。
