{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T04:31:04Z","timestamp":1786336264039,"version":"build-2736575974"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"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>Sudden Unexpected Death in Epilepsy (SUDEP) represents a leading cause of epilepsy-related mortality, reflecting a severe disruption of systemic physiology that remains challenging to address using standard clinical protocols. Although generalized tonic\u2013clonic seizures (GTCS) and pharmacoresistance are established risk indicators, current clinical risk stratification frequently lacks the predictive granularity required to anticipate individual cardiorespiratory collapse. This review provides a comprehensive synthesis of the SUDEP pathophysiological framework, aiming to bridge the gap between retrospective clinical observation and proactive precision medicine. We delineate a translational framework focused on the intrinsic biological susceptibility of the neuro-cardiac axis, particularly the genetic \u201cdual pathology\u201d of channelopathies and structural cardiac remodeling. Furthermore, we evaluate the transition from reactive risk identification toward multimodal \u201cdigital phenotyping\u201d leveraging artificial intelligence. Finally, we assess the developmental trajectory of \u201csecondary prevention\u201d strategies, such as automated neurostimulation, designed to interrupt the terminal cascade. By integrating genomic vulnerability with emerging preventative technologies, this review outlines a multidisciplinary approach to transforming SUDEP into a more predictable and preventable clinical entity.<\/jats:p>","DOI":"10.3389\/fneur.2026.1916085","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T04:23:00Z","timestamp":1786335780000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pathophysiological frameworks and emerging preventative strategies in SUDEP"],"prefix":"10.3389","volume":"17","author":[{"given":"Chenxi","family":"Xu","sequence":"first","affiliation":[{"name":"First Clinical Medical College of Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"Department of Encephalopathy, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyuan","family":"Wang","sequence":"additional","affiliation":[{"name":"First Clinical Medical College of Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"Department of Encephalopathy, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suping","family":"Nie","sequence":"additional","affiliation":[{"name":"First Clinical Medical College of Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"Department of Encephalopathy, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Gao","sequence":"additional","affiliation":[{"name":"First Clinical Medical College of Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"Department of Encephalopathy, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxiang","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Encephalopathy, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1212\/WNL.0000000000003509","article-title":"Prevalence and incidence of epilepsy: a systematic review and meta-analysis of international 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