A woman with epilepsy died during a seizure and the event was recorded on ambulatory EEG. The circumstances were typical of SUDEP. The EEG revealed that the patient had had a generalised seizure that abruptly ended with cessation of all cerebral electrical activity. Two other cases recorded on videotelemetry demonstrating similar EEG features were reported in the literature. We postulate that abrupt irreversible Cerebral Electrical Shutdown (CES) during a seizure may be the primary mechanism of SUDEP.
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