Plötzlicher, unerwarteter Tod bei Epilepsie

Robert Daniel Nass; Rainer Surges

doi:10.1055/a-0981-4004

Nervenheilkunde, Table of Contents

Nervenheilkunde 2019; 38(12): 936-942
DOI: 10.1055/a-0981-4004

Schwerpunkt

Plötzlicher, unerwarteter Tod bei Epilepsie

Übersicht über Ursachen und PräventionSudden, unexpected death in epilepsy

Authors

Robert Daniel Nass∗

¹Klinik und Poliklinik für Epileptologie, Universitätsklinikum Bonn
Rainer Surges

¹Klinik und Poliklinik für Epileptologie, Universitätsklinikum Bonn

Abstract

ZUSAMMENFASSUNG

Der plötzliche, unerwartete Tod eines Menschen mit Epilepsie wird mit dem englischen Akronym SUDEP bezeichnet (sudden unexpected death in epilepsy). Etwa einer von 1000 Epilepsiepatienten stirbt hieran, vor allem jene mit häufigeren nächtlichen generalisierten konvulsiven Anfällen. Die Mehrzahl der SUDEP-Fälle ist durch postiktuale Störungen der Atem- und Kreislauffunktion mit primärer zentraler Apnoe und sekundärer Asystolie verursacht. Die beteiligten zellulären Pathomechanismen sind jedoch noch ungeklärt. Die Aufklärung aller Patienten und Angehörigen wird durch angloamerikanische Fachgesellschaften empfohlen und von den meisten auch gewünscht. Entscheidend für die Prävention ist eine konsequente Anfallskontrolle. Zudem kann eine nächtliche Supervision das Risiko für SUDEP relevant mindern, dafür stehen klinisch geprüfte alltagstaugliche Anfallsdetektionssysteme zur Verfügung.

ABSTRACT

Sudden, unexpected death in epilepsy (SUDEP) affects about 1 in 1000 people with epilepsy. The most important risk factors are nocturnal and generalized convulsive seizures. Postictal primary central apnoea and secondary bradycardia and asystole cause SUDEP probably in most cases, the underlying cellular pathomechanisms are not elucidated yet. Comprehensive information of patients and relatives is recommended by medical societies in the USA and UK and desired by most patients and relatives. Full seizure control is key to SUDEP prevention. Nocturnal supervision significantly reduces the SUDEP risk, appropriate and clinically tested seizure detection systems are available.

Schlüsselwörter

SUDEP - Epilepsie - Anfälle - Prävention

Key words

SUDEP - epilepsy - seizures - prevention

Full Text

References

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