Sudden death and epilepsy.

• Case–control Study of SUDEP Langan Y, Nashef L, Sander JW Neurology 2005;64:1131–1133 To examine the influence of various factors on the risk of sudden unexpected death in epilepsy (SUDEP). Methods The authors investigated 154 cases in which a postmortem examination was performed. Each case had four controls with epilepsy from the community, matched for age and geographic location. Backward stepwise conditional logistic regression analysis was performed, and odds ratios for risk and protection were determined. Results The risk of SUDEP was increased with a history of generalized tonic–clonic seizures in the previous 3 months (odds ratio [OR]: 13.8; 95% CI: 6.6 to 29.1). The presence of supervision at night was found to be protective (OR: 0.4; 95% CI: 0.2 to 0.8) when a supervising individual shared the same bedroom or when special precautions such as a listening device were used (OR: 0.1; 95% CI: 0.0 to 0.3). Conclusions This work lends support to the view that SUDEP is a seizure-related phenomenon and that control of tonic–clonic seizures is important in its prevention. Nocturnal supervision seems to protect against SUDEP.

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