Comparison of Antiepileptic Drug Levels in Sudden Unexpected Deaths in Epilepsy with Deaths from Other Causes

Summary: Purpose: (a) To compare postmortem antiepileptic drug (AED) levels in patients with sudden unexpected death in epilepsy (SUDEP) with those in a control group of subjects with epilepsy. If SUDEP patients more frequently had undetectable or subtherapeutic AED levels, this would suggest that compliance with AED treatment is poorer in this group and that poor compliance is a risk factor for SUDEP. (b) To determine whether a particular AED was detected more commonly in the SUDEP group, suggesting that this AED is associated with a higher risk of SUDEP.

[1]  J A Perper,et al.  Unexpected, unexplained death in epileptic patients , 1975, Neurology.

[2]  J. Troncoso,et al.  Evaluation of Sudden Death in Epilepsy , 1986, The American journal of forensic medicine and pathology.

[3]  D. Chadwick,et al.  Sudden death and epilepsy , 1990, The Lancet.

[4]  J. Annegers,et al.  Cohort Study of Incidence of Sudden Unexplained Death in Persons with Seizure Disorder Treated with Antiepileptic Drugs in Saskatchewan, Canada , 1995, Epilepsia.

[5]  L. Kuller,et al.  Sudden and unexpected natural death in childhood and adolescence. , 1985, JAMA.

[6]  L. Nashef,et al.  Sudden unexpected deaths in epilepsy—where are we now? , 1996, Seizure.

[7]  T. B. Cole,et al.  Sudden unexplained death in young persons with primary epilepsy , 1992 .

[8]  Paul Schraeder,et al.  Sudden Unexplained Death in Epilepsy: Observations from a Large Clinical Development Program , 1997, Epilepsia.

[9]  T. May,et al.  Postmortem Concentrations of Phenobarbital, Carbamazepine, and Its Metabolite Carbamazepine‐10,11‐Epoxide in Different Regions of the Brain and in the Serum: Analysis of Autoptic Specimens from 51 Epileptic Patients , 1993, Therapeutic drug monitoring.

[10]  C. S. Hirsch,et al.  Unexpected death in young epileptics , 1971, Neurology.

[11]  W. Theodore.  Suicide and epilepsy. , 1980, British medical journal.

[12]  K. Hossack,et al.  The Sudden Unexplained Death Syndrome in Epilepsy: Demographic, Clinical, and Postmortem Features , 1992, Epilepsia.

[13]  Stephen W. Brown,et al.  Coroners' autopsy reporting of sudden unexplained death in epilepsy (SUDEP) in the UK , 1994, Seizure.

[14]  T. May,et al.  Postmortem Serum Protein Binding and Brain Concentrations of Antiepileptic Drugs in Autoptic Specimens from 45 Epileptic Patients , 1990, Therapeutic drug monitoring.

[15]  T. May,et al.  Postmortem Concentrations of Phenytoin in Different Regions of the Brain and in the Serum: Analysis of Autoptic Specimens from 24 Epileptic Patients , 1992, Therapeutic drug monitoring.

[16]  G G Davis,et al.  Comparison of anti-epileptic drug levels in different cases of sudden death. , 1998, Journal of forensic sciences.

[17]  R. Dasheiff,et al.  Sudden unexpected death of epileptic patient due to cardiac arrhythmia after seizure. , 1986, Archives of neurology.

[18]  J E Leestma,et al.  A prospective study on sudden unexpected death in epilepsy , 1989, Annals of neurology.

[19]  G. Jay,et al.  Sudden Unexpected Death Associated with Seizures: Analysis of 66 Cases , 1984, Epilepsia.

[20]  P. Timmings,et al.  Sudden unexpected death in epilepsy: a local audit , 1993, Seizure.