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They had a typical high <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content> risk profile with longstanding intractable epilepsy and frequent generalized tonic\u2013clonic seizures (<jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content>). All patients had varying patterns of respiratory and bradyarrhythmic cardiac dysfunction with profound electroencephalography (<jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>) suppression. In two patients, patterns of cardiorespiratory failure were similar to those seen in some patients in the Mortality in Epilepsy Monitoring Units Study (<jats:styled-content style=\"fixed-case\">MORTEMUS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content> almost always occur postictally, after <jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content> and less commonly after a partial seizure. Monitored <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content> or near\u2010<jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content> cases without a seizure have not yet been reported in literature. When nonmonitored <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content> occurs in an ambulatory setting without an overt seizure, the absence of <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> information prevents the exclusion of a subtle seizure. These cases confirm the existence of nonseizure <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content>; such deaths may not be prevented by seizure detection\u2013based devices. <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content> risk in patients with epilepsy may constitute a spectrum of susceptibility wherein some are relatively immune, death occurs in others with frequent <jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content> with one episode of seizure ultimately proving fatal, while in others still, death may occur even in the absence of a seizure. We emphasize the heterogeneity of <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content> phenomena.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.13419","type":"journal-article","created":{"date-parts":[[2016,5,25]],"date-time":"2016-05-25T06:34:58Z","timestamp":1464158098000},"page":"1161-1168","source":"Crossref","is-referenced-by-count":100,"title":["Nonseizure SUDEP: Sudden unexpected death in epilepsy without preceding epileptic seizures"],"prefix":"10.1111","volume":"57","author":[{"given":"Samden D.","family":"Lhatoo","sequence":"first","affiliation":[{"name":"Epilepsy Center UH Case Medical Center Cleveland Ohio U.S.A."},{"name":"NINDS Center for SUDEP Research (CSR; Center without Walls)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maromi","family":"Nei","sequence":"additional","affiliation":[{"name":"NINDS Center for SUDEP Research (CSR; Center without Walls)"},{"name":"Jefferson Comprehensive Epilepsy Center Thomas Jefferson University Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Raghavan","sequence":"additional","affiliation":[{"name":"Adult Comprehensive Epilepsy Center Medical College of Wisconsin Milwaukee Wisconsin U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sperling","sequence":"additional","affiliation":[{"name":"Jefferson Comprehensive Epilepsy Center Thomas Jefferson University Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Zonjy","sequence":"additional","affiliation":[{"name":"Epilepsy Center UH Case Medical Center Cleveland Ohio U.S.A."},{"name":"NINDS Center for SUDEP Research (CSR; Center without Walls)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Lacuey","sequence":"additional","affiliation":[{"name":"Epilepsy Center UH Case Medical Center Cleveland Ohio U.S.A."},{"name":"NINDS Center for SUDEP Research (CSR; Center without Walls)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orrin","family":"Devinsky","sequence":"additional","affiliation":[{"name":"NINDS Center for SUDEP Research (CSR; Center without Walls)"},{"name":"NYU Langone Comprehensive Epilepsy Center New York University Langone Medical Center New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.64.3.349"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.57.3.430"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.67.4.439"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.68.2.211"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70214-X"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1542\/peds.94.2.148","article-title":"Epileptic seizure\u2010induced hypoxemia in infants with apparent life\u2010threatening events","volume":"94","author":"Hewertson J","year":"1994","journal-title":"Pediatrics"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1010481"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13134"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2011.03358.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.58.4.462"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.56.2.149"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1997.tb01076.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1992.tb02321.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410260203"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2005.11404.x"},{"key":"e_1_2_8_17_1","first-page":"69","article-title":"Cardiac arrhythmias during or after epileptic seizures","volume":"87","author":"Lende M","year":"2016","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0013-9580.2004.05503.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004691-199104000-00010"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000335760.02995.ca"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001755"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24596"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2015.07.005"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12251"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt332"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aaa4050"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01781.x"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fepi.13419","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.13419","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T13:18:29Z","timestamp":1696339109000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.13419"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,25]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,7]]}},"alternative-id":["10.1111\/epi.13419"],"URL":"https:\/\/doi.org\/10.1111\/epi.13419","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5,25]]}}}