A case report sudden unexpected deaths in epilepsy with concomitant neuropathologies A case series

Sudden death is one of the global health problems. There is no uniform definition to diagnose sudden death. According to the World Health Organization, (ICD 10) any death which is sudden, non-violent and not otherwise explained, occurring less than 24 hours from the onset of symptoms is classified as sudden death.[¹] The most common cause of sudden deaths is cardiac cause. According to ICD 11 (for Morbidity and Mortality statistics) Sudden unexpected death in epilepsy (SUDEP) is a category of death in people with epilepsy in whom death occurs under benign circumstances and in the absence of known structural causes of death (i.e. not due to drowning, injury, intoxication and other internal or external factors).[²] Sudden deaths, more so in younger age group is common in individuals with epilepsy. Epilepsy, is defined according to the International League Against Epilepsy (ILAE), as at least two unprovoked seizures occurring more than 24 h apart or a single unprovoked seizure, with a recurrence risk of at least 60% over the next 10 years or an identifiable epileptic syndrome.[³] About 80% of individuals with epilepsy are estimated to be living in lower and middle-income countries.[⁴] Sudden unexpected death in epilepsy (SUDEP) is a category of death in people with epilepsy occurring in the absence of a known structural cause of death and is most likely multifactorial with regard to mechanisms and circumstances.[⁵] The authors report autopsy findings seen in a series of sudden deaths in known epileptic individuals.