Sudden unexpected death in epilepsy: A subject that spans from neurology to forensic sciences and genetics.

Sudden unexpected death in epilepsy (SUDEP) is one of the most devastating complications of epilepsy, posing a significant challenge for clinicians, geneticists, and forensic specialists. It is defined as a sudden, unexpected, nontraumatic, and nondrowning death in individuals with epilepsy, with no...

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Publicado en:Turkish Journal of Neurology Vol. 32; no. 1; pp. 1 - 11
Autores principales: Danışman, Sude, Beşkoç, Caner, Yücesan, Emrah, Akçakaya, Nihan Hande
Formato: review tables/charts Journal Article
Publicado: Galenos Yayinevi Tic. LTD. STI 2026
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Galenos Yayinevi Tic. LTD. STI
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        atl: Sudden unexpected death in epilepsy: A subject that spans from neurology to forensic sciences and genetics.
      aug:
        au:
          Danışman, Sude
          Beşkoç, Caner
          Yücesan, Emrah
          Akçakaya, Nihan Hande
        affil: Department of Neurogenetics, İstanbul University - Cerrahpaşa, Institute of Neurological Sciences, İstanbul, Türkiye
      sug:
        subj:
          Epilepsy Complications
          Genetics Evaluation
          Autopsy Methods
          Molecular Diagnostic Techniques
          Sudden Unexpected Death in Epilepsy Epidemiology
          Sudden Unexpected Death in Epilepsy Classification
          Sudden Unexpected Death in Epilepsy Risk Factors
          Sudden Unexpected Death in Epilepsy Familial and Genetic
          Sudden Unexpected Death in Epilepsy Physiopathology
          Genetic Screening
          Sequence Analysis
          Risk Assessment
          Prediction Models
          Heart Defects, Congenital
          Anemia, Sickle Cell
          Respiration Disorders
          Electroencephalography
      ab: Sudden unexpected death in epilepsy (SUDEP) is one of the most devastating complications of epilepsy, posing a significant challenge for clinicians, geneticists, and forensic specialists. It is defined as a sudden, unexpected, nontraumatic, and nondrowning death in individuals with epilepsy, with no identifiable toxicological or anatomical cause found during postmortem examination. It accounts for a significant portion of epilepsy-related mortality. The heterogeneous nature of SUDEP complicates accurate diagnosis, classification, and epidemiological assessment, particularly in cases lacking comprehensive death scene investigation or autopsy. Emerging evidence suggests that SUDEP is a multifactorial phenomenon involving complex interactions between seizure-induced respiratory dysfunction, autonomic instability, and cardiac arrhythmogenesis. Findings from monitored cases indicate that terminal apnea often precedes cardiac arrest, underscoring the central role of postictal respiratory failure. However, conventional autopsy often fails to reveal specific structural abnormalities, making SUDEP a diagnosis of exclusion in forensic practice. The integration of molecular autopsy has significantly advanced the understanding of SUDEP by identifying pathogenic variants in genes associated with cardiac channelopathies and epilepsy syndromes. Next-generation sequencing technologies have enabled comprehensive genetic screening in autopsy-negative cases, linking neuronal excitability and cardiac electrophysiology. These findings highlight the shared molecular mechanisms underlying epilepsy and sudden cardiac death and offer opportunities for family-based risk assessment and preventive interventions. A multidisciplinary approach that combines clinical evaluation, standardized forensic investigation, and genomic analysis is essential to improve diagnostic accuracy and risk stratification. Continued research integrating genetic, physiological, and epidemiological data is crucial to advancing precision medicine strategies and reducing the global burden of SUDEP.
      pubtype: Academic Journal
      doctype:
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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