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Sudden Unexpected Death in Epilepsy: Mechanisms and New Methods for
Analyzing Risks builds on earlier works focusing on the clinical
problem of sudden unexpected death in epilepsy (SUDEP). This book
presents a methodology for identifying and classifying clusters of
risks that lead to SUDEP. Developed over the last two years, the
SUDEP Classification System and Risk Factor Cluster ID method will
help to address gaps in our knowledge about the causes and possible
prevention of this tragic complication. Exploring the interactions
among the central and peripheral autonomic nervous systems and the
cardiopulmonary systems, the book includes case studies of SUDEP,
definite or probable, as well as near miss cases. It discusses how
neurologists, emergency room physicians, and attending physicians
can identify individuals at possible risk for SUDEP and lessen the
chance of occurrence. Top medical professionals in the field detail
the development of an international database of human cases and
animal models of SUDEP and suggest how medical examiner and coroner
offices can strengthen the database by providing information about
incidences of SUDEP. In addition, the book describes related
clinical and animal studies needed to classify risk factors for
SUDEP victims. Understanding the risk factors and mechanisms
underlying SUDEP will facilitate collaborative research in the
laboratory, hospital, and clinic and lead to improved effectiveness
of SUDEP prevention strategies.
Though it is one of the most common causes of death in epilepsy
patients, SUDEP is still infrequently and even reluctantly named on
autopsy reports. This under-reporting equates to a lack of
attention and earnest investigation into the cause, predisposition,
and prevention of SUDEP. There is as yet little effort to establish
an actionable strategy in the mitigation of these potentially fatal
arrhythmias. Expanding on the 1990 book Epilepsy and Sudden Death,
edited by Lathers and Schraeder, Sudden Death in Epilepsy: Forensic
and Clinical Issues reviews of the basic science of epilepsy as it
relates to SUDEP. Clinical chapters study the sophisticated
simultaneous ambulatory EKG and EEG telemetry and respiratory
function monitoring of patients at risk for sudden death that will
help identify cardiac, respiratory, and epileptogenic interactions
involved. Chapters on animal models evaluate new data from studies
that build on previously used models and emphasize that multiple
models are needed to investigate the pathophysiology of SUDEP, to
hypothesize about effective treatments, to develop pilot studies in
persons with epilepsy, and to conduct confirmatory large-scale
clinical trials. Contributions discuss the interaction between the
central and peripheral autonomic nervous systems and the
cardiopulmonary systems; proposed mechanistic factors in SUDEP;
risk categories of arrhythmogenic, respiratory, and hypoxia related
cardiac death; psychological, emotional, and stress related
factors; the role of alcohol and drugs in seizures; and the
potential mitigating properties of antiepileptic medication.
Adopting a global, multidisciplinary focus to address the mystery
of SUDEP, this important work provides clinicians, researchers,
patients, and families with the knowledge to freely discuss the
phenomenon and thereby discover the preventive treatment regimens
to decrease the occurrence of SUDEP.
Sudden Unexpected Death in Epilepsy: Mechanisms and New Methods for
Analyzing Risks builds on earlier works focusing on the clinical
problem of sudden unexpected death in epilepsy (SUDEP). This book
presents a methodology for identifying and classifying clusters of
risks that lead to SUDEP. Developed over the last two years, the
SUDEP Classification System and Risk Factor Cluster ID method will
help to address gaps in our knowledge about the causes and possible
prevention of this tragic complication. Exploring the interactions
among the central and peripheral autonomic nervous systems and the
cardiopulmonary systems, the book includes case studies of SUDEP,
definite or probable, as well as near miss cases. It discusses how
neurologists, emergency room physicians, and attending physicians
can identify individuals at possible risk for SUDEP and lessen the
chance of occurrence. Top medical professionals in the field detail
the development of an international database of human cases and
animal models of SUDEP and suggest how medical examiner and coroner
offices can strengthen the database by providing information about
incidences of SUDEP. In addition, the book describes related
clinical and animal studies needed to classify risk factors for
SUDEP victims. Understanding the risk factors and mechanisms
underlying SUDEP will facilitate collaborative research in the
laboratory, hospital, and clinic and lead to improved effectiveness
of SUDEP prevention strategies.
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