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J Neurol Neurosurg Psychiatry 1999;67:427 doi:10.1136/jnnp.67.4.427
  • Editorial commentary

From mystery to prevention: sudden unexpected death in epilepsy, time to move on

  1. L NASHEF
  1. Department of Neurology, Kent and Canterbury Hospital, Ethelbert Road, Canterbury CT1 3NG, UK

      This noteworthy paper of Kloster and Engelskohn in this issue (pp 439–44) supports an important hypothesis in relation to the cause of sudden unexpected death in epilepsy (SUDEP)—namely, that SUDEP is largely seizure related. Their finding of a preponderance of the prone position of the body is also of interest and may have a bearing on proposed mechanisms as well as the potential for the prevention of these deaths.

      But firstly, certain methodological aspects should be noted. The control group of non-SUDEP deceased epilepsy cases is not appropriate for all variables studied. Epilepsy diagnosis is an example. The non-SUDEP group would include cases dying of the underlying condition causing or associated with the epilepsy and is expected to …

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