Cardiovascular Genetics Center, University of Girona-IDIBGI, 17003 Salt, Spain.
Section of Legal Medicine, Institute of Public Health, Catholic University, Fondazione Policlinico A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, 00168 Rome, Italy.
Int J Mol Sci. 2019 Apr 23;20(8):1979. doi: 10.3390/ijms20081979.
Epilepsy is a common neurological disorder associated with increased morbidity and mortality. Sudden unexpected death in epilepsy, also known as SUDEP, is the main cause of death in patients with epilepsy. SUDEP has an incidence of 1.2 per 1000 person-years in adults and 0.2 per 1000 person-years in children. SUDEP accounts for 8-17% of deaths in patients with epilepsy. It is commonly associated with a history of generalized tonic-clonic seizures, and its risk may be increased by other factors such as postictal electroencephalographic suppression, prone sleeping position, altered heart rate variability, conduction abnormalities, gender, or antiepileptic medications. Recently, electrocardiograms, electroencephalograms, and imaging markers have helped clinicians stratify SUDEP risk and identify patients in need of close monitoring. However, the pathophysiology of SUDEP is likely multifactorial and still unknown. Improving the knowledge of SUDEP incidence, risk factors, and biomarkers can help design and implement effective prevention strategies.
癫痫是一种常见的神经系统疾病,与发病率和死亡率的增加有关。癫痫猝死,又称 SUDEP,是癫痫患者死亡的主要原因。成人中 SUDEP 的发病率为每 1000 人年 1.2 例,儿童中为每 1000 人年 0.2 例。SUDEP 占癫痫患者死亡人数的 8-17%。它通常与全身性强直阵挛性发作史有关,其风险可能会因其他因素而增加,如发作后脑电图抑制、俯卧位、心率变异性改变、传导异常、性别或抗癫痫药物。最近,心电图、脑电图和影像学标志物有助于临床医生对 SUDEP 风险进行分层,并确定需要密切监测的患者。然而,SUDEP 的病理生理学可能是多因素的,目前仍不清楚。提高对 SUDEP 发病率、危险因素和生物标志物的认识,可以帮助设计和实施有效的预防策略。