Reducing the Risk of Sudden Unexpected Death in Epilepsy (SUDEP)

  • Lance Watkins
  • Rohit ShankarEmail author
Epilepsy (E Waterhouse, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Epilepsy


Purpose of Review

Recent reports have highlighted an increase in the number of epilepsy-related deaths. Sudden unexpected death in epilepsy (SUDEP) is thought to be the number one cause of death in chronic epilepsy. This review provides a summary of the current evidence of how to communicate, stratify, and mitigate known risk factors for SUDEP.

Recent Findings

There is now a clearer understanding of the possible pathological mechanisms that contribute to SUDEP. SUDEP is the culmination of multifactorial predisposing and precipitating factors and has been linked to particular candidate genes. A number of static and modifiable risk factors for SUDEP have been consistently identified. Recent guidance has emphasised the importance of communicating SUDEP risk to individuals at the earliest appropriate time.


SUDEP risk assessment should be integral to the care of individuals with epilepsy. The use of evidence-based risk assessment tools may provide an opportunity to communicate identified risks in a person-centred holistic way. There is increasing evidence to support the use of wearable seizure monitoring devices to help reduce the frequency and impact of convulsive seizures, perhaps the number one risk factor for SUDEP.


Risk factors Preventable death Mechanism 


Compliance with Ethical Standards

Conflict of Interest

Rohit Shankar is a stakeholder of the ‘SUDEP and Seizure Safety Checklist’. Rohit Shankar is a principal developer and key stakeholder of EpSMon. Rohit Shankar has received institutional and research support and personal fees from LivaNova, UCB, Eisai, Special Products, Bial and Desitin.

Lance Watkins has no disclosures to report.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neath Port Talbot CLDT, Mental Health & Learning Disability Delivery UnitAbertawe Bro Morgannwg University Health BoardSwanseaUK
  2. 2.Cornwall Partnership NHS Foundation TrustTruroUK
  3. 3.Exeter Medical School, Knowledge SpaRoyal Cornwall HospitalTruroUK

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