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

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dc.contributor.authorHarden, Cynthia
dc.contributor.authorTomson, Torbjoern
dc.contributor.authorGloss, David
dc.contributor.authorBuchhalter, Jeffrey
dc.contributor.authorCross, J. Helen
dc.contributor.authorDonner, Elizabeth
dc.contributor.authorFrench, Jacqueline A.
dc.contributor.authorGil-Nagel, Anthony
dc.contributor.authorHesdorffer, Dale C.
dc.contributor.authorSmithson, W. Henry
dc.contributor.authorSpitz, Mark C.
dc.contributor.authorWalczak, Thaddeus S.
dc.contributor.authorSander, Josemir W.
dc.contributor.authorRyvlin, Philippe
dc.contributor.funderAmerican Academy of Neurology
dc.date.accessioned2018-06-15T11:47:15Z
dc.date.available2018-06-15T11:47:15Z
dc.date.issued2017
dc.description.abstractObjective: To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified. Methods: Systematic review of evidence; modified Grading Recommendations Assessment, Development, and Evaluation process for developing conclusions; recommendations developed by consensus. Results: Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0-17 years) is 0.22/1,000 patient-years (95% confidence interval [CI] 0.16-0.31) (moderate confidence in evidence). SUDEP risk increases in adults to 1.2/1,000 patient-years (95% CI 0.64-2.32) (low confidence in evidence). The major risk factor for SUDEP is the occurrence of generalized tonic-clonic seizures (GTCS); the SUDEP risk increases in association with increasing frequency of GTCS occurrence (high confidence in evidence). Recommendations: Level B: Clinicians caring for young children with epilepsy should inform parents/guardians that in 1 year, SUDEP typically affects 1 in 4,500 children; therefore, 4,499 of 4,500 children will not be affected. Clinicians should inform adult patients with epilepsy that SUDEP typically affects 1 in 1,000 adults with epilepsy per year; therefore, annually 999 of 1,000 adults will not be affected. For persons with epilepsy who continue to experience GTCS, clinicians should continue to actively manage epilepsy therapies to reduce seizures and SUDEP risk while incorporating patient preferences and weighing the risks and benefits of any new approach. Clinicians should inform persons with epilepsy that seizure freedom, particularly freedom from GTCS, is strongly associated with decreased SUDEP risk.en
dc.description.statusPeer reviewed
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationHarden, C., Tomson, T., Gloss, D., Buchhalter, J., Cross, J. H., Donner, E., French, J. A., Gil-Nagel, A., Hesdorffer, D. C., Smithson, W. H., Spitz, M. C., Walczak, T. S., Sander, J. W. and Ryvlin, P. (2017) '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, 88(17), pp. 1674-1680. doi: 10.1212/WNL.0000000000003685en
dc.identifier.doi10.1212/WNL.0000000000003685
dc.identifier.endpage1680
dc.identifier.issn0028-3878
dc.identifier.issued17
dc.identifier.journaltitleNeurologyen
dc.identifier.startpage1674
dc.identifier.urihttps://hdl.handle.net/10468/6341
dc.identifier.volume88
dc.language.isoenen
dc.publisherLippincott, Williams & Wilkinsen
dc.relation.urihttp://n.neurology.org/content/88/17/1674
dc.rights© 2017, American Academy of Neurology. All rights reserved.en
dc.subjectChildhood-onset epilepsyen
dc.subjectUnexplained deathen
dc.subjectAntiepileptic drugsen
dc.subjectNerve-stimulationen
dc.subjectLong-termen
dc.subjectMortalityen
dc.subjectSUDEPen
dc.subjectCohorten
dc.subjectSeizuresen
dc.subjectDefinitionsen
dc.titlePractice 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 Societyen
dc.typeArticle (peer-reviewed)en
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