Risk Factors for Sudden Unexpected Death in Epilepsy (SUDEP) and Their Mitigation

  • Robyn Whitney
  • Elizabeth J. DonnerEmail author
Pediatric Neurology (A Yeshokumar, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Pediatric Neurology


Purpose of review

People with epilepsy have an increased risk of mortality when compared to the general population. Sudden unexpected death in epilepsy (SUDEP) is the most common cause of epilepsy-related death in children and adults. The purpose of this review is to discuss SUDEP, with an emphasis on SUDEP risk factors, their mitigation and prevention.

Recent findings

SUDEP affects approximately 1 in 1000 people with epilepsy each year. Recent studies suggest that the incidence in children is similar to that of adults. The most important risk factor for SUDEP is the presence and frequency of generalized tonic-clonic seizures. The presence of nocturnal supervision may decrease risk along with the use of nocturnal listening devices. Underlying genetic influences, both cardiac and epilepsy-related may further alter risk. Risk mitigation strategies include reducing seizure frequency, optimizing therapy, and the use of nocturnal supervision/seizure detection devices.


Risk factors for SUDEP are well established; however, pediatric specific risk factors have not been identified. Current prevention strategies are focused on reduction of risk factors and the possible role of seizure detection devices. More research is needed to better understand the varied underlying pathological mechanisms and develop targeted prevention strategies. Further understanding the genetic factors that influence SUDEP risk may potentially aid in understanding the underlying pathophysiology of SUDEP.


SUDEP Epilepsy mortality Risk factors Risk mitigation Prevention 


Compliance with Ethical Standards

Conflict of Interest

Elizabeth J. Donner reports personal fees from Eisai, personal fees from UCB, outside the submitted work. Robyn Whitney declares that she has no conflict of interest.

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 importance •• Of major importance

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Authors and Affiliations

  1. 1.Division of Neurology, Department of PaediatricsThe Hospital for Sick ChildrenTorontoCanada

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