SUDEP – more attention to the heart? A narrative review on molecular autopsy in epilepsy. (April 2021)

• Record Type: Journal Article
• Authors: Fialho, Guilherme L.; Wolf, Peter; Walz, Roger; Lin, Katia
• Is Part Of: Seizure. Volume 87(2021)
• Page Start: 103
• Page End: 106
• Publication Date: 2021-04
• Subjects: Sudden death -- Epilepsy -- SUDEP -- Molecular autopsy -- Genetic autopsy; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2021.03.010
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Patients with epilepsy (PWE) have an increased risk for sudden unexpected death (SUDEP). Autopsy negative sudden death (SD) in general population shares some similarities to SUDEP. In forensic medicine, cases of SD not explained by a pathological and toxicological examination can be considered a sudden arrhythmic death syndrome (SADS). Molecular autopsy is defined as the forensic search for molecular/genetic markers of disease. SUDEP classification should embrace recent findings related to genetics and molecular autopsy. Abstract: Sudden unexpected death in epilepsy (SUDEP) has been identified as one of the most prevalent causes of mortality in epilepsy, and SUDEP has consequently become an important topic of research. The causes appear multifactorial, including epilepsy-induced cardiac arrest. Current understanding of autopsy negative sudden unexplained death (SUD) in general population and its relation to sudden arrhythmic death syndrome (SADS) could shed some light in SUDEP. Mutual attention to the findings of sudden death in cardiology and epilepsy are discussed here. We performed a narrative review on SUDEP, epilepsy and molecular/genetic autopsy in this population. A proposal of an extended terminology for SUDEP classification is discussed in light of recent issues related to molecular autopsy and genetics. The extended classification might be a step forward in research protocols and a tool for better understanding SUDEP.