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癫痫性猝死(SUDEP)峰会:临床行动、认知、公共卫生与流行病学以及基础科学方面的建议和优先事项

Sudden Unexpected Death in Epilepsy (SUDEP) Summit: Recommendations and priorities for clinical action, awareness, public health and epidemiology, and basic science.

作者信息

Iyengar Sloka S, Lapham Gardiner, Buchhalter Jeffrey R, Buchanan Gordon F, Donner Elizabeth J, Dumanis Sonya B, Grzeskowiak Caitlin L, Fureman Brandy E, Hirsch Lawrence J, Kukla Alison, Middleton Owen L, Isom Lori L, Friedman Daniel, Schaeffer Sally, Auerbach David S

机构信息

Cure Epilepsy, PO Box 10572, Chicago, IL 60610, USA.

Partners Against Mortality in Epilepsy, 135 South LaSalle Street, Suite 2850, Chicago, IL 60603, USA.

出版信息

Epilepsy Behav. 2025 Oct;171:110648. doi: 10.1016/j.yebeh.2025.110648. Epub 2025 Aug 11.

Abstract

BACKGROUND

It remains difficult to predict who will succumb to Sudden Unexpected Death in Epilepsy (SUDEP). As the mechanisms for SUDEP remain unknown, there are not adequate strategies to prevent SUDEP. Thus, some providers are reluctant to discuss SUDEP risk with patients. Public health surveillance and prevention efforts are limited. The SUDEP Summit aimed to identify gaps in the field and prioritize recommendations to advance basic science, clinical care, and public health approaches to mitigate SUDEP.

METHODS

In 2020, a diverse group of stakeholders formed the four SUDEP Summit workgroups: 1. Clinical Action, 2. Awareness and Behavior Change, 3. Public Health and Epidemiology, and 4. Basic Science.

RESULTS

Each workgroup defined priorities for action and necessary resources and partners; outlined challenges and barriers; defined metrics of success; and developed short and long-term goals. Workgroups discussed methods to prioritize SUDEP research and develop educational materials for healthcare professionals to raise awareness about the risks of SUDEP. Since the meeting, progress has been made in alignment with the workgroups' recommendations. These include studies examining the use of wearables, clinical trials reporting SUDEP rates, tools to improve SUDEP education, policies to improve SUDEP reporting, SUDEP risk calculators, new clinically relevant models, and standardization of data collection.

SIGNIFICANCE

Advancements in SUDEP awareness, education, epidemiology, and causal mechanisms require interdisciplinary collaborative approaches between funding agencies, advocacy groups, providers, and researchers; and the development of new partnerships. More work remains to achieve the recommendations from the Summit, which highlight the fundamental importance of coordinating efforts to mitigate and end SUDEP.

摘要

背景

预测哪些癫痫患者会突然意外死亡(SUDEP)仍然很困难。由于SUDEP的发病机制尚不清楚,目前尚无足够的预防策略。因此,一些医疗服务提供者不愿与患者讨论SUDEP风险。公共卫生监测和预防工作也很有限。SUDEP峰会旨在找出该领域的差距,并优先提出建议,以推进基础科学、临床护理和公共卫生方法,降低SUDEP风险。

方法

2020年,一群不同的利益相关者组成了四个SUDEP峰会工作组:1. 临床行动;2. 认知与行为改变;3. 公共卫生与流行病学;4. 基础科学。

结果

每个工作组都确定了行动重点、所需资源和合作伙伴;概述了挑战和障碍;定义了成功的衡量标准;并制定了短期和长期目标。工作组讨论了确定SUDEP研究优先级的方法,并为医疗保健专业人员开发教育材料,以提高对SUDEP风险的认识。自会议以来,已按照工作组的建议取得了进展。这些进展包括研究可穿戴设备的使用、报告SUDEP发生率的临床试验、改善SUDEP教育的工具、改善SUDEP报告的政策、SUDEP风险计算器、新的临床相关模型以及数据收集的标准化。

意义

提高对SUDEP的认识、开展教育、进行流行病学研究以及了解因果机制,需要资助机构、倡导团体、医疗服务提供者和研究人员之间采取跨学科合作方法,并建立新的伙伴关系。要实现峰会的建议仍有更多工作要做,这些建议强调了协调各方努力以减轻和消除SUDEP的根本重要性。

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