Plötzlicher, unerwarteter Tod bei Epilepsie: Mechanismen und Prävention

Max Christian Pensel; Rainer Surges

doi:10.1055/a-0626-6263

Klinische Neurophysiologie, Table of Contents

Klinische Neurophysiologie 2018; 49(03): 133-142
DOI: 10.1055/a-0626-6263

CME-Fortbildung

Plötzlicher, unerwarteter Tod bei Epilepsie: Mechanismen und Prävention

Sudden, Unexpected Death in Epilepsy: Mechanisms and Preventive Strategies.

Max Christian Pensel

,

Rainer Surges

Abstract

Zusammenfassung

SUDEP ist ein Akronym aus dem Englischen (sudden, unexpected death in epilepsy) und benennt den plötzlichen, unerwarteten Tod von Menschen mit Epilepsie. Es handelt sich um eine seltene, aber gravierende Gefahr für Epilepsiepatienten. Im Folgenden soll gezeigt werden, welche Mechanismen und Risikofaktoren eine Rolle spielen und wie das Auftreten von SUDEP verhindert werden kann.

Abstract

SUDEP is an english acronym for „sudden, unexpected death in epilepsy“. It describes a rare but severe risk for patients with epilepsy. This article gives an overview of the mechanisms and risk factors for SUDEP and gives advice for SUDEP prevention.

Key words

SUDEP - sudden unexpected death in epilepsy - generalized tonic-clonic seizure - seizure control

Schlüsselwörter

SUDEP - plötzlicher - unerwarteter Tod bei Epilepsie - generalisierter tonisch-klonischer Anfall - Anfallskontrolle

Full Text

References

Literatur
1 Nashef L, So EL, Ryvlin P. et al. Unifying the definitions of sudden unexpected death in epilepsy. Epilepsia 2012; 53: 227-233
2 Nilsson L, Farahmand BY, Persson P-G. et al. Risk factors for sudden unexpected death in epilepsy: A case control study. The Lancet 1999; 353: 888-893
3 Harden C, Tomson T, Gloss D. et al. Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2017; 88: 1674-1680
4 Lhatoo SD, Sander JWAS. Cause-specific mortality in epilepsy. Epilepsia 2005; 46 (Suppl. 11) 36-39
5 Hesdorffer DC, Tomson T, Benn E. et al. Do antiepileptic drugs or generalized tonic-clonic seizure frequency increase SUDEP risk? A combined analysis. Epilepsia 2012; 53: 249-252
6 Lamberts RJ, Thijs RD, Laffan A. et al Sudden unexpected death in epilepsy: People with nocturnal seizures may be at highest risk. Epilepsia 2012; 53: 253-257
7 Monté CPJA, Arends JBAM, Tan IY. et al. Sudden unexpected death in epilepsy patients: Risk factors. A systematic review. Seizure 2007; 16: 1-7
8 George JR, Davis GG. Comparison of anti-epileptic drug levels in different cases of sudden death. J Forensic Sci 1998; 43: 598-603
9 Clark D, Riney K. A population-based post mortem study of sudden unexpected death in epilepsy. J Clin Neurosci 2016; 23: 58-62
10 Surges R, Thijs RD, Tan HL. et al. Sudden unexpected death in epilepsy: risk factors and potential pathomechanisms. Nat Rev Neurol 2009; 5: 492-504
11 Langan Y, Nashef L, Sander JW. Case-control study of SUDEP. Neurology 2005; 64: 1131-1133
12 Neligan A, Bell GS, Johnson AL. et al. The long-term risk of premature mortality in people with epilepsy. Brain 2011; 134 Pt 2 388-395
13 Bell GS, Gaitatzis A, Bell CL. et al. Drowning in people with epilepsy: How great is the risk?. Neurology 2008; 71: 578-582
14 Ficker DM, So EL, Shen WK. et al. Population-based study of the incidence of sudden unexplained death in epilepsy. Neurology 1998; 51: 1270-1274
15 Thurman DJ, Hesdorffer DC, French JA. Sudden unexpected death in epilepsy: Assessing the public health burden. Epilepsia 2014; 55: 1479-1485
16 Ryvlin P, Nashef L, Lhatoo SD. et al. Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): A retrospective study. The Lancet Neurology 2013; 12: 966-977
17 Hirsch LJ. Is sudden unexpected death in epilepsy due to postictal brain shutdown?. Ann Neurol 2010; 68: 773-775
18 Aiba I, Noebels JL. Spreading depolarization in the brainstem mediates sudden cardiorespiratory arrest in mouse SUDEP models. Sci Transl Med 2015; 7: 282ra46
19 Kloster R, Engelskjøn T. Sudden unexpected death in epilepsy (SUDEP): A clinical perspective and a search for risk factors. J Neurol Neurosurg Psychiatry 1999; 67: 439-444
20 Bateman LM, Li C-S, Seyal M. Ictal hypoxemia in localization-related epilepsy: Analysis of incidence, severity and risk factors. Brain 2008; 131 Pt 12 3239-3245
21 Nashef L, Walker F, Allen P. et al. Apnoea and bradycardia during epileptic seizures: Relation to sudden death in epilepsy. J Neurol Neurosurg Psychiatry 1996; 60: 297-300
22 Darnell JC, Jay SJ. Recurrent postictal pulmonary edema: A case report and review of the literature. Epilepsia 1982; 23: 71-83
23 Romero Osorio OM, Abaunza Camacho JF, Sandoval Briceño D. et al. Postictal neurogenic pulmonary edema: Case report and brief literature review. Epilepsy Behav Case Rep 2018; 9: 49-50
24 Seyal M, Bateman LM, Albertson TE. et al. Respiratory changes with seizures in localization-related epilepsy: Analysis of periictal hypercapnia and airflow patterns. Epilepsia 2010; 51: 1359-1364
25 Tomson T, Nashef L, Ryvlin P. Sudden unexpected death in epilepsy: Current knowledge and future directions. Lancet Neurol 2008; 7: 1021-1031
26 Lamberts RJ, Laranjo S, Kalitzin SN. et al. Postictal generalized EEG suppression is not associated with periictal cardiac autonomic instability in people with convulsive seizures. Epilepsia 2013; 54: 523-529
27 Peng W, Danison JL, Seyal M. Postictal generalized EEG suppression and respiratory dysfunction following generalized tonic-clonic seizures in sleep and wakefulness. Epilepsia 2017; 58: 1409-1414
28 Lamberts RJ, Gaitatzis A, Sander JW. et al. Postictal generalized EEG suppression: An inconsistent finding in people with multiple seizures. Neurology 2013; 81: 1252-1256
29 Dasheiff RM, Dickinson LJ. Sudden unexpected death of epileptic patient due to cardiac arrhythmia after seizure. Arch Neurol 1986; 43: 194-196
30 Espinosa PS, Lee JW, Tedrow UB. et al. Sudden unexpected near death in epilepsy: Malignant arrhythmia from a partial seizure. Neurology 2009; 72: 1702-1703
31 Jeppesen J, Fuglsang-Frederiksen A, Brugada R. et al. Heart rate variability analysis indicates preictal parasympathetic overdrive preceding seizure-induced cardiac dysrhythmias leading to sudden unexpected death in a patient with epilepsy. Epilepsia 2014; 55: e67-e71
32 Lotufo PA, Valiengo L, Benseñor IM. et al. A systematic review and meta-analysis of heart rate variability in epilepsy and antiepileptic drugs. Epilepsia 2012; 53: 272-282
33 Surges R, Jordan A, Elger CE. Ictal modulation of cardiac repolarization, but not of heart rate, is lateralized in mesial temporal lobe epilepsy. PLoS ONE 2013; 8: e64765
34 Duplyakov D, Golovina G, Lyukshina N. et al. Syncope, seizure-induced bradycardia and asystole: Two cases and review of clinical and pathophysiological features. Seizure 2014; 23: 506-511
35 Fava I, Del Gaudio S, Volpe E. et al. The ictal bradycardia syndrome: A case report. Epilepsy Behav Case Rep 2015; 4: 9-12
36 Wasterlain CG, Fujikawa DG, Penix L. et al. Pathophysiological mechanisms of brain damage from status epilepticus. Epilepsia 1993; 34 (Suppl. 01) S37-S53
37 Stöllberger C, Wegner C, Finsterer J. Seizure-associated Takotsubo cardiomyopathy. Epilepsia 2011; 52: e160-e167
38 Shmuely S, van der Lende M, Lamberts RJ. et al. The heart of epilepsy: Current views and future concepts. Seizure 2017; 44: 176-183
39 Hampel KG, Jahanbekam A, Elger CE. et al. Seizure-related modulation of systemic arterial blood pressure in focal epilepsy. Epilepsia 2016; 57: 1709-1718
40 Bozorgi A, Chung S, Kaffashi F. et al. Significant postictal hypotension: Expanding the spectrum of seizure-induced autonomic dysregulation. Epilepsia 2013; 54: e127-e130
41 Hampel KG, Elger CE, Surges R. Impaired Baroreflex Sensitivity after Bilateral Convulsive Seizures in Patients with Focal Epilepsy. Front. Neurol 2017; 8: 210
42 Jehi L, Najm IM. Sudden unexpected death in epilepsy: Impact, mechanisms, and prevention. Cleve Clin J Med 2008; 75 (Suppl. 02) S66-S70
43 Lhatoo SD, Nei M, Raghavan M. et al. Nonseizure SUDEP: Sudden unexpected death in epilepsy without preceding epileptic seizures. Epilepsia 2016; 57: 1161-1168
44 Tecott LH, Sun LM, Akana SF. et al. Eating disorder and epilepsy in mice lacking 5-HT2c serotonin receptors. Nature 1995; 374: 542-546
45 Venit EL, Shepard BD, Seyfried TN. Oxygenation prevents sudden death in seizure-prone mice. Epilepsia 2004; 45: 993-996
46 Tupal S, Faingold CL. Evidence supporting a role of serotonin in modulation of sudden death induced by seizures in DBA/2 mice. Epilepsia 2006; 47: 21-26
47 Faingold CL, Randall M, Tupal S. DBA/1 mice exhibit chronic susceptibility to audiogenic seizures followed by sudden death associated with respiratory arrest. Epilepsy Behav 2010; 17: 436-440
48 Uteshev VV, Tupal S, Mhaskar Y. et al. Abnormal serotonin receptor expression in DBA/2 mice associated with susceptibility to sudden death due to respiratory arrest. Epilepsy Res 2010; 88: 183-188
49 Shen H-Y, Li T, Boison D. A novel mouse model for sudden unexpected death in epilepsy (SUDEP): Role of impaired adenosine clearance. Epilepsia 2010; 51: 465-468
50 Ryvlin P, Nashef L, Tomson T. Prevention of sudden unexpected death in epilepsy: A realistic goal?. Epilepsia 2013; 54 (Suppl. 02) 23-28
51 Glasscock E. Genomic biomarkers of SUDEP in brain and heart. Epilepsy Behav 2014; 38: 172-179
52 Wandschneider B, Koepp M, Scott C. et al. Structural imaging biomarkers of sudden unexpected death in epilepsy. Brain 2015; 138 Pt 10 2907-2919
53 Mueller SG, Bateman LM, Laxer KD. Evidence for brainstem network disruption in temporal lobe epilepsy and sudden unexplained death in epilepsy. Neuroimage Clin 2014; 5: 208-216
54 Hesdorffer DC, Tomson T, Benn E. et al. Combined analysis of risk factors for SUDEP. Epilepsia 2011; 52: 1150-1159
55 Hughes JR. A review of sudden unexpected death in epilepsy: Prediction of patients at risk. Epilepsy Behav 2009; 14: 280-287
56 Smith AW, Mara CA, Modi AC. Adherence to antiepileptic drugs in adolescents with epilepsy. Epilepsy Behav 2018; 80: 307-311
57 Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med 2000; 342: 314-319
58 Seymour N, Granbichler CA, Polkey CE. et al. Mortality after temporal lobe epilepsy surgery. Epilepsia 2012; 53: 267-271
59 Ryvlin P, So EL, Gordon CM. et al. Long-term surveillance of SUDEP in drug-resistant epilepsy patients treated with VNS therapy. Epilepsia 2018; 59: 562-572
60 Faingold CL, Randall M, Zeng C. et al. Serotonergic agents act on 5-HT3 receptors in the brain to block seizure-induced respiratory arrest in the DBA/1 mouse model of SUDEP. Epilepsy Behav 2016; 64 Pt A 166-170
61 Kanner AM, Kozak AM, Frey M. The Use of Sertraline in Patients with Epilepsy: Is It Safe?. Epilepsy Behav 2000; 1: 100-105
62 Thomé-Souza MS, Kuczynski E, Valente KD. Sertraline and fluoxetine: Safe treatments for children and adolescents with epilepsy and depression. Epilepsy Behav 2007; 10: 417-425
63 Favale E, Rubino V, Mainardi P. et al. Anticonvulsant effect of fluoxetine in humans. Neurology 1995; 45: 1926-1927
64 Specchio LM, Iudice A, Specchio N. et al. Citalopram as treatment of depression in patients with epilepsy. Clin Neuropharmacol 2004; 27: 133-136
65 Bateman LM, Li C-S, Lin T-C. et al. Serotonin reuptake inhibitors are associated with reduced severity of ictal hypoxemia in medically refractory partial epilepsy. Epilepsia 2010; 51: 2211-2214
66 Richerson GB, Boison D, Faingold CL. et al. From unwitnessed fatality to witnessed rescue: Pharmacologic intervention in sudden unexpected death in epilepsy. Epilepsia 2016; 57 (Suppl. 01) 35-45
67 Boison D, Sandau US, Ruskin DN. et al. Homeostatic control of brain function – new approaches to understand epileptogenesis. Front Cell Neurosci 2013; 7: 109
68 Catcheside PG, Mohtar AA, Reynolds KJ. Airflow resistance and CO2 rebreathing properties of anti-asphyxia pillows designed for epilepsy. Seizure 2014; 23: 462-467
69 Xu Z, Ayyappan S, Seneviratne U. Sudden unexpected death in epilepsy (SUDEP): What do patients think?. Epilepsy Behav 2015; 42: 29-34
70 Surges R, Wrede Rv, Porschen T. et al. Knowledge of sudden unexpected death in epilepsy (SUDEP) among 372 patients attending a German tertiary epilepsy center. Epilepsy Behav 2018; 80: 360-364
71 Royal College of Physicians (UK) . The Epilepsies: The Diagnosis and Management of the Epilepsies in Adults and Children in Primary and Secondary Care: Pharmacological Update of Clinical Guideline 20. London: 2012
72 Knapp P, Raynor DK, Berry DC. Comparison of two methods of presenting risk information to patients about the side effects of medicines. Qual Saf Health Care 2004; 13: 176-180
73 Kahneman D, Tversky A. Choices, values, and frames. American Psychologist 1984; 39: 341-350
74 Shankar R, Cox D, Jalihal V. et al. Sudden unexpected death in epilepsy (SUDEP): development of a safety checklist. Seizure 2013; 22: 812-817