{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:27:26Z","timestamp":1791397646182,"version":"4.3.3"},"reference-count":139,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Sudden unexpected death in epilepsy (SUDEP) is sudden, unexpected, witnessed or unwitnessed, nontraumatic, non-drowning death that occurs in a person with epilepsy. SUDEP is the leading cause of epilepsy-related death in adults with epilepsy, with an incidence of about 1.2 per 1000 person-years in the general epilepsy population. Recent studies have shown similar prevalence in the pediatric population too. Although the precise mechanism remains unclear, well-documented cases of SUDEP suggest that a generalized tonic clonic seizure-induced, centrally mediated change in cardiorespiratory function leads to terminal apnea and cardiac arrest. Risk factors include generalized tonic clonic seizure frequency, duration of epilepsy, nocturnal seizure, and certain genetic syndromes. Orexin, adenosine, and serotonin neurotransmission have been explored as novel drug targets to mitigate SUDEP risk. Neurostimulation and resective epilepsy surgery have been reported to have beneficial effects on long-term SUDEP risk as well. Future studies may aim to clarify the role of sleep and other comorbidities in SUDEP pathophysiology.<\/jats:p>","DOI":"10.3390\/jcm14103329","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T09:13:38Z","timestamp":1747041218000},"page":"3329","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Sudden Unexpected Death in Epilepsy: A Narrative Review of Mechanism, Risks, and Prevention"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3394-262X","authenticated-orcid":false,"given":"Rena Y.","family":"Jiang","sequence":"first","affiliation":[{"name":"College of Medicine, University of South Florida Morsani, Tampa, FL 33602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0992-8476","authenticated-orcid":false,"given":"Robin T.","family":"Varughese","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Cohen Children\u2019s Medical Center, Northwell, New Hyde Park, NY 11042, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev V.","family":"Kothare","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Cohen Children\u2019s Medical Center, Northwell, New Hyde Park, NY 11042, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1111\/epi.12579","article-title":"Prevalence of Epilepsy\u2014An Unknown Quantity","volume":"55","author":"Beghi","year":"2014","journal-title":"Epilepsia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/j.1750-3639.2010.00438.x","article-title":"Post-Mortem Review and Genetic Analysis of Sudden Unexpected Death in Epilepsy (SUDEP) Cases","volume":"21","author":"Tu","year":"2011","journal-title":"Brain Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1111\/j.1528-1157.1995.tb01061.x","article-title":"Sudden Death in Epilepsy: A Study of Incidence in a Young Cohort with Epilepsy and Learning Difficulty","volume":"36","author":"Nashef","year":"1995","journal-title":"Epilepsia"},{"key":"ref_4","doi-asserted-by":"crossref","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":"ref_5","doi-asserted-by":"crossref","first-page":"119","DOI":"10.23907\/2018.009","article-title":"National Association of Medical Examiners Position Paper: Recommendations for the Investigation and Certification of Deaths in People with Epilepsy","volume":"8","author":"Middleton","year":"2018","journal-title":"Acad. 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