{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:58:12Z","timestamp":1779893892247,"version":"3.53.1"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Epilepsy is a common neurological disorder that is associated with increased morbidity and mortality. Sudden unexpected death in epilepsy (SUDEP) is one of the most common causes for epilepsy-related deaths and its characteristics remain largely unknown, particularly from a forensic autopsy perspective. The present study aimed to investigate the neurological, cardiac, and pulmonary findings for a total of 388 SUDEP decedents, encompassing three cases from our forensic center during 2011\u20132020 and 385 literature-reported autopsy cases. In the cases mentioned in this study, two of them presented with only mild cardiac abnormalities, such as focal myocarditis and mild coronary atherosclerosis of the left anterior coronary artery. The third one was negative of any pathological findings. After pooling together these SUDEP cases, we found that neurological changes (<jats:italic>n<\/jats:italic> = 218 cases, 56.2%) were the most common postmortem findings associated with SUDEP, with cerebral edema\/congestion (<jats:italic>n<\/jats:italic> = 60 cases, 15.5%) and old traumatic brain injury (<jats:italic>n<\/jats:italic> = 58 cases, 14.9%) being the major findings. Interstitial fibrosis, myocyte disarray\/hypertrophy, and mild coronary artery atherosclerosis were the most common findings related to primary cardiac pathology, documented in 49 (12.6%), 18 (4.6%), and 15 (3.9%) cases, respectively. Non-specific pulmonary edema was the major finding in the lungs. This is an autopsy-based study that reports the scenario of postmortem findings for SUDEP cases. Our study paves the way for understanding the pathogenesis of SUDEP and the interpretation of death.<\/jats:p>","DOI":"10.3389\/fneur.2023.1126652","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T10:27:40Z","timestamp":1676543260000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Sudden unexpected death in epilepsy: Investigation of autopsy-based studies"],"prefix":"10.3389","volume":"14","author":[{"given":"Fengping","family":"Yan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1111\/j.1528-1167.2011.03358.x","article-title":"Unifying the definitions of sudden unexpected death in epilepsy","volume":"53","author":"Nashef","year":"2012","journal-title":"Epilepsia."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1111\/epi.12666","article-title":"Sudden unexpected death in epilepsy: assessing the public health burden","volume":"55","author":"Thurman","year":"2014","journal-title":"Epilepsia."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1674","DOI":"10.1212\/WNL.0000000000003685","article-title":"Practice guideline summary: sudden unexpected death in epilepsy incidence rates and risk factors: report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology and the American Epilepsy Society","volume":"88","author":"Harden","year":"2017","journal-title":"Neurology."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1016\/S1474-4422(16)30158-2","article-title":"Sudden unexpected death in epilepsy: epidemiology, mechanisms, and prevention","volume":"15","author":"Devinsky","year":"2016","journal-title":"Lancet Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1111\/ane.13049","article-title":"Sudden unexpected death in epilepsy: risk factors, biomarkers, and prevention","volume":"139","author":"DeGiorgio","year":"2019","journal-title":"Acta Neurol Scand."},{"key":"B6","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1111\/nan.12453","article-title":"Review: the past, present and future challenges in epilepsy-related and sudden deaths and biobanking","volume":"44","author":"Thom","year":"2018","journal-title":"Neuropathol Appl Neurobiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"101920","DOI":"10.1016\/j.jflm.2020.101920","article-title":"Review on post-mortem diagnosis in suspected SUDEP: currently still a difficult task for forensic pathologists","volume":"70","author":"Barranco","year":"2020","journal-title":"J Forensic Leg Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.seizure.2018.12.007","article-title":"Sudden unexpected death in epilepsy: the neuro-cardio-respiratory connection","volume":"64","author":"Manolis","year":"2019","journal-title":"Seizure."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1002\/acn3.51382","article-title":"The brain-heart interaction in epilepsy: implications for diagnosis, therapy, and SUDEP prevention","volume":"8","author":"Costagliola","year":"2021","journal-title":"Ann Clin Transl Neurol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.seizure.2021.03.010","article-title":"SUDEP\u2014more attention to the heart? 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