Sudden Unexpected Death in Epilepsy During Ambulatory Video-EEG Monitoring at Home

Authors

• Jonathan Ross
• Ivana Tyrlikova
• Alexander Giermek
• Manuela Ochoa-Urrea
• Samden Lhatoo
• Pavel Klein

Language

English

Publication Date

1-23-2024

Journal

Neurology

DOI

10.1212/WNL.0000000000208041

PMID

38165346

PMCID

PMC10870738

PubMedCentral® Posted Date

12-22-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Background and objectives: We report the recording of sudden unexpected death in epilepsy (SUDEP) in a 68-year-old man with recent onset cryptogenic epilepsy, captured by video-EEG monitoring, at home in the company of his wife while sitting in a chair. This was only the third seizure of his life, the first 2 occurring 19 days previously. This rare event is a novel case of SUDEP recorded with ambulatory video EEG at home. The video is included by permission.

Methods: Electroclinical seizure and cardiorespiratory analysis was ascertained using a combination of video, EEG (Natus, standard 10-20 electrode), ECG, and sound. Respiratory rate was ascertained based on chest, abdominal, and facial respiratory movements, together with video and audio.

Results: The unique video-EEG recording illustrates the time course of apnea and bradycardia leading to terminal apnea in conjunction with prolonged postictal generalized EEG suppression.

Discussion: This case is illustrative of a wide spectrum of SUDEP cases, ranging from the highly intractable to the patient with newly diagnosed epilepsy with very few seizures. It illustrates that patients can succumb to SUDEP while awake and in the sitting position (1) very early in their epilepsy course, (2) without recognized risk factors other than generalized convulsive seizures, (3) even when accompanied.

Keywords

Male, Humans, Aged, Sudden Unexpected Death in Epilepsy, Apnea, Death, Sudden, Epilepsy, Electroencephalography, Seizures

Published Open-Access

yes

Recommended Citation

Ross, Jonathan; Tyrlikova, Ivana; Giermek, Alexander; et al., "Sudden Unexpected Death in Epilepsy During Ambulatory Video-EEG Monitoring at Home" (2024). Faculty, Staff and Student Publications. 3779.
https://digitalcommons.library.tmc.edu/uthmed_docs/3779