Jiang Rena Y, Varughese Robin T, Kothare Sanjeev V
College of Medicine, University of South Florida Morsani, Tampa, FL 33602, USA.
Division of Pediatric Neurology, Cohen Children's Medical Center, Northwell, New Hyde Park, NY 11042, USA.
J Clin Med. 2025 May 10;14(10):3329. doi: 10.3390/jcm14103329.
Sudden unexpected death in epilepsy (SUDEP) is sudden, unexpected, witnessed or unwitnessed, nontraumatic, non-drowning death that occurs in a person with epilepsy. SUDEP is the leading cause of epilepsy-related death in adults with epilepsy, with an incidence of about 1.2 per 1000 person-years in the general epilepsy population. Recent studies have shown similar prevalence in the pediatric population too. Although the precise mechanism remains unclear, well-documented cases of SUDEP suggest that a generalized tonic clonic seizure-induced, centrally mediated change in cardiorespiratory function leads to terminal apnea and cardiac arrest. Risk factors include generalized tonic clonic seizure frequency, duration of epilepsy, nocturnal seizure, and certain genetic syndromes. Orexin, adenosine, and serotonin neurotransmission have been explored as novel drug targets to mitigate SUDEP risk. Neurostimulation and resective epilepsy surgery have been reported to have beneficial effects on long-term SUDEP risk as well. Future studies may aim to clarify the role of sleep and other comorbidities in SUDEP pathophysiology.
癫痫性猝死（SUDEP）是指癫痫患者发生的突然、意外、有目击者或无目击者、非创伤性、非溺水死亡。SUDEP是成年癫痫患者癫痫相关死亡的主要原因，在一般癫痫人群中的发病率约为每1000人年1.2例。最近的研究表明，儿科人群中的患病率也相似。尽管确切机制尚不清楚，但有充分记录的SUDEP病例表明，全身性强直阵挛性发作引起的、中枢介导的心肺功能改变会导致终末期呼吸暂停和心脏骤停。危险因素包括全身性强直阵挛性发作频率、癫痫病程、夜间发作以及某些遗传综合征。食欲素、腺苷和血清素神经传递已被探索为减轻SUDEP风险的新型药物靶点。据报道，神经刺激和切除性癫痫手术对长期SUDEP风险也有有益影响。未来的研究可能旨在阐明睡眠和其他合并症在SUDEP病理生理学中的作用。
